692
Correspondence
If every endotracheal tube was marked in a similar fashion by the manufacturers I feel that the incidence of inadvertent endobronchial intubation would be reduced almost to zero. Intensive Therapy Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne, NE1 4LP
J. C. STODDART
A simple method with a well lubricated cuffed tube is to very gently withdraw the tube until the correctly inflated cuff is felt to engage on the under side of the vocal cordsEditor.
Flunitrazepam in Dental Outpatients
Flunitrazepam is a fluorinated benzodiazepine, the structure of which is similar to diazepam and nitrazepam. It was decided to assess its suitability for use in outpatient dental anaesthesia. Ten adult patients (7 male and 3 female) whose average weight was 64'7 kg and average age was 28.7 years were given a single intravenous dose of 3 mg of Flunitrazepam. This dose produced a loss of consciousness in all but one patient but did not, alone, produce satisfactory operating conditions. Nitrous oxide, oxygen and halothane was administered by a nasal mask and 4 cases required 5 ml of 5 % propranadid. Muttering, movement, salivation and coughing occurred in 5 cases following induction. In one of the patients, who had been given atropine prior to induction, excessive movement was so troublesome that propranadid had to be given to control it. Hiccough and laryngeal spasm occurred in one patient. The main disadvantage of Flunitrazepam in these circumstances is the prolonged recovery time which does not occur with standard techniques. The average duration of the surgery was 14 minutes but the average recovery time was 52 minutes. None of the patients vomited or complained of headache, or nausea but amnesia was sometimes marked, one patient claiming to be unable to remember anything in the 76 hours following recovery. It would appear, therefore, that flunitrazepam is a totally unsuitable agent for use in out-patients undergoing dental surgery-of short duration. It may have a place as an intravenous sedative in association with local analgesia for prolonged conservative work. Aberdeen Royal Infirmary, Aberdeen
W. N. ROLLASON
A Simple Method of Recording the Ventilator History of a Patient It is sometimes difficult to keep track of patients with difficult respiratory problems and I now use a code which can be recorded every day when the patient is examined. In the expression 3 (1) 2 (4) 5 the figures in brackets refer to the period when the patient is completely off the ventilator and the other figures refer to times when he is still being ventilated or weaned. National Heart Hospital, Westmoreland Street, London, W I M 8BA
ALANGILSTON
Correspondence
If every endotracheal tube was marked in a similar fashion by the manufacturers I feel that the incidence of inadvertent endobronchial intubation would be reduced almost to zero. Intensive Therapy Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne, NE1 4LP
J. C. STODDART
A simple method with a well lubricated cuffed tube is to very gently withdraw the tube until the correctly inflated cuff is felt to engage on the under side of the vocal cordsEditor.
Flunitrazepam in Dental Outpatients
Flunitrazepam is a fluorinated benzodiazepine, the structure of which is similar to diazepam and nitrazepam. It was decided to assess its suitability for use in outpatient dental anaesthesia. Ten adult patients (7 male and 3 female) whose average weight was 64'7 kg and average age was 28.7 years were given a single intravenous dose of 3 mg of Flunitrazepam. This dose produced a loss of consciousness in all but one patient but did not, alone, produce satisfactory operating conditions. Nitrous oxide, oxygen and halothane was administered by a nasal mask and 4 cases required 5 ml of 5 % propranadid. Muttering, movement, salivation and coughing occurred in 5 cases following induction. In one of the patients, who had been given atropine prior to induction, excessive movement was so troublesome that propranadid had to be given to control it. Hiccough and laryngeal spasm occurred in one patient. The main disadvantage of Flunitrazepam in these circumstances is the prolonged recovery time which does not occur with standard techniques. The average duration of the surgery was 14 minutes but the average recovery time was 52 minutes. None of the patients vomited or complained of headache, or nausea but amnesia was sometimes marked, one patient claiming to be unable to remember anything in the 76 hours following recovery. It would appear, therefore, that flunitrazepam is a totally unsuitable agent for use in out-patients undergoing dental surgery-of short duration. It may have a place as an intravenous sedative in association with local analgesia for prolonged conservative work. Aberdeen Royal Infirmary, Aberdeen
W. N. ROLLASON
A Simple Method of Recording the Ventilator History of a Patient It is sometimes difficult to keep track of patients with difficult respiratory problems and I now use a code which can be recorded every day when the patient is examined. In the expression 3 (1) 2 (4) 5 the figures in brackets refer to the period when the patient is completely off the ventilator and the other figures refer to times when he is still being ventilated or weaned. National Heart Hospital, Westmoreland Street, London, W I M 8BA
ALANGILSTON
