Fast tracheal intubation with adminstration of ephedrine before atracurium

The most important duty of anesthesiologist is to maintain a secure airway that in emergency patients by injection of intravenous anesthetic drugs such as nesdonal and succinylcholine, tracheal intubation is performed with a 30-45 second delay. But in cases that succinylcholine is contraindicated, nondepolarizing muscle relaxant like atracurium is injected and tracheal intubation is performed with a 3-5 minute delay. The aim of this study was to compare the effect of atracurium and ephedrine with atracurium alone for shortening the time of tracheal intubation. One hundred patients [ASA class I] were randomly divided into two groups of 50 cases. Induction of anesthesia was performed in both groups with nesdonal and then atracurium with dose 0.6mg/kg was administered in both groups. After premedication in case group, ephedrine with dose 70 micro g/kg was performed. In control group, tracheal intubation was performed 3-5 minutes after injection atracurium. Systolic and diastolic blood pressure and heart rate were measured and recorded at different times and also intubaion condition was recorded and data was compared. The mean age was 26.3 +/- 10 years in case group and 31.4 +/- 10 years in control group. In case group, tracheal intubation was performed in all patients during 2 minutes. After anesthesia induction, systolic and diastolic blood pressure decreased and heart rate increased in both groups, but there was a significant difference after intubation at minute 1 and 5 [p<0.05]. Quality of tracheal intubation was seen in 88% of subjects in case group and 96% of subjects in control group, this difference was not statistically significant. Ephedrine can cause a decrease in the onset time of atracurium and faster intubation without adverse hemodynamic effect

[Effectiveness of glutaraldehyde in disinfecting of endoscopes]

Introduction and Objective: one of the main approaches for control of infections and preventing of nosocomial infection is by using antiseptics and disinfectants. There are reports regarding transmission of infection through those endoscopes which have not been properly disinfected. This study aimed to find out the effect of glutaraldehyde on those bacteria which might be transmitted by endoscope

Materials and Methods: samples were taken from the disinfectant in 14 days. The first days of sampling was considered as the activation day of the glutaraldehyde solution. Sampling was done on the cleaning machine every day after the end of each run for 14 days. The disinfectant have been circulated a total of 121 times in the washing machine which the endoscopes. Glutaraldehyde solution was tested for Staphylococcus aureus, Enterococcus, E.coli, Pseudomonas aeroginosa, Salmonella typhi and Mycobacterium tuberculosis in everyday

Results: results of this study show that after 20 min, the disinfectant had a proper complete effect on killing of the gram positive and negative bacteria. Effect of this disinfectant on Mycobacterium tuberculosis was somewhat different. At first we did not have any growth relating to the Mycobacterium tuberculosis but using the disinfectant 6 days its activation, the colonies started to grow in the culture media. We planned to study the number of times, which the disinfectant had cycled in the endoscopes washing machines. The results showed that after 74 times the disinfectant had lost its ability to kill Mycobacterium tuberculosis [even before 14 days]

Conclusion: glutaraldehyde loses its effectiveness on killing of M. tuberculosis if used in several cycles in endoscopes washing mashines