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Table 1.  Clinical Description of the 23 Cases of Bronchospasm
Case Number
 Age (yr)
 Hx of RAD
 Muscle Relaxant
 Type of Induction
 Summary of Narrative Comments
 Treatment
1 1 Yes Rapacuronium Inhaled Initially no breath sounds and no Petco2. Bronchospasm noted after intubation Repeat DL confirms ETT in trachea, albuterol inhalation
2 2 Yes Rapacuronium RSI No comments about wheezing ETT suctioned, albuterol inhalation
3 3 Yes Rapacuronium RSI Severe bronchospasm noted immediately after intubation, Albuterol inhalation, ETT suctioned
4 7 Yes Rapacuronium RSI Immediately postintubation, difficulty ventilating, decreased Petco2, coarse breath sounds on right, and decreased breath sounds on left with mild rhonchi Albuterol inhalation, ETT suctioned
5 0.5 No Rapacuronium RSI After intubation, bronchospasm noted, with bilateral decreased breath sounds Increase in desflurane concentration and hand ventilation
6 0.5 No Rapacuronium RSI Wheezing on induction No treatment
7 11 No Rapacuronium RSI Severe wheezing after intubation with inability to ventilate Repeat DL confirms ETT in trachea, ETT changed, albuterol inhalation, ETT suctioned
8 7 Yes Rapacuronium RSI Bronchospasm after intubation Albuterol inhalation, ETT suctioned
9 7 Yes Rapacuronium RSI Bilateral expiratory wheezes noted after induction and intubation Albuterol inhalation
10 10 No Rapacuronium RSI Breath sounds diminished bilaterally, mild wheezing ETT suctioned
11 8 No Rapacuronium RSI Postintubation bronchospasm noted Albuterol inhalation
12 8 Yes Rapacuronium RSI Acute bronchospasm after intubation associated with desaturation Albuterol inhalation
13 0.17 No Vecuronium Inhaled Rhonchi noted bilaterally, PIP = 24 Albuterol inhalation
14 0.17 No Vecuronium Inhaled Expiratory wheezing and chest tightness Albuterol inhalation
15 6 No Vecuronium RSI Expiratory wheezing and increase in PIP Albuterol inhalation, ventilation setting changed
16 14 Yes Pancuronium RSI Wheezing and diminished breath sounds bilaterally Albuterol inhalation
17 0.92 No Vecuronium Inhaled Wheezing noted after intubation ETT suctioned, albuterol inhalation
18 1.67 Yes Vecuronium Inhaled Bronchospasm noted after induction Hand ventilated, albuterol inhalation
19 7 No Vecuronium Inhaled Slight wheezes noted after induction Albuterol inhalation, ETT suctioned
20 14 No Mivacurium Inhaled No comments about wheezing Albuterol inhalation
21 12 Yes Cisatracurium RSI No comments about wheezing Albuterol inhalation
22 13 Yes Mivacurium Inhaled No comments about wheezing Albuterol inhalation
23
 5
 No
 Pancuronium
 Inhaled
 No comments about wheezing
 Albuterol inhalation
DL = direct laryngoscopy; ETT = endotracheal tube; Petco2 = end-tidal carbon dioxide; PIP = peak inspiratory pressures; RAD = reactive airways disease; RSI = rapid or modified rapid sequence induction.





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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press