Anesthesiologist, how do you suppress the extubation reaction?

The landing of the plane is the most exciting time, and certainly the most dangerous time

The landing of the plane is the most exciting time, and certainly the most dangerous time

What I can do is to try my best to give the patient the most suitable drug dosage and proper treatment.

There are too many factors affecting the first two questions.

There are too many factors affecting the first two questions.

The cough reflex arc includes four links: the cough reflex arc includes four links:

1.

1.

2.

3.

4.

Specifically, the whole process of coughing is like this: a short inhalation, then the glottis closes immediately, and the diaphragm drops at the same time, and then the respiratory muscles and diaphragm muscles contract rapidly, causing the intrapulmonary pressure to increase sharply, and then the glottis opens suddenly, and the lungs The internal high-pressure air jets out and hits the narrow glottal crack, erupting a special sound

During the operation, the patient was in a tube-in state.

1.

Intravenous injection before extubation, 1mg/kg is recommended ; applying lidocaine glue during intubation also has a certain preventive effect

2.

Small doses of opioids before extubation also have a good effect

3.
Dexmedetomidine

Because it may affect the recovery, the pump injection is started 40 minutes before the end of the operation , the dosage is 0.
5ug/kg , and the pump injection is 10 minutes
.

Because it may affect the recovery, the pump injection is started 40 minutes before the end of the operation , the dosage is 0.
5ug/kg , and the pump injection is 10 minutes
.

4.
Esmolol

4.
Esmolol

The choking reaction results in sympathetic excitement and the release of catecholamines
.
Esmolol 1.
5 mg/kg intravenously for 2-5 minutes before extubation can significantly inhibit cardiovascular response .
The use of vasodilators for brain surgery patients can cause cerebral vasodilation, leading to increased cerebral blood volume and increased intracranial pressure.
It is recommended that the alpha and beta receptor blocker labetalol .

The choking reaction results in sympathetic excitement and the release of catecholamines
.
Esmolol 1.
5 mg/kg intravenously for 2-5 minutes before extubation can significantly inhibit cardiovascular response .
The use of vasodilators for brain surgery patients can cause cerebral vasodilation, leading to increased cerebral blood volume and increased intracranial pressure.
It is recommended that the alpha and beta receptor blocker labetalol .

In clinical practice, the above methods can be used alone or in combination
.
Personally, there is a great demand for postoperative analgesia for operations such as thoracotomy and laparotomy, and I like to inject medium and long-acting opioids, which can not only meet the analgesic requirements when waking up, but also greatly inhibit the withdrawal.
Tube reaction
.

In clinical practice, the above methods can be used alone or in combination
.
Personally, there is a great demand for postoperative analgesia for operations such as thoracotomy and laparotomy, and I like to inject medium and long-acting opioids, which can not only meet the analgesic requirements when waking up, but also greatly inhibit the withdrawal.
Tube reaction
.


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