sihi Posted May 26, 2012 Author Share Posted May 26, 2012 (edited) I agree Suxamethon creates good condition for intubation. If use paralytics Midazolam sedation is ok, better with opiate premedication. I work in two services in the "south" and in the "north". In the south we have suxamethon, pipicuronium, propofol, midazolam, Sodium Oxybate, morphine. But some leader phisicians say that we - nurses, shouldnt use propofol or paralytics for intubation. Here I have used anestetics. Comatose patient in septic shock, hyperventilating. I ensured vasopressive and inotrope support and inducted anesthesia with ~15 mg Midazolam (less hypotensive drug) and 40 Propofol (although pretty hypotnsive and cardiodepressive drug) ---> I got good condition for intub. I didnt used suxamethon becouse didnt want to have problems with "leader" phisicians:) For this patient I would better use 15 midazolam and suxamethon ofcourse. Next he got anesthetic Sodium Oxybate - very good in shock. In the north we have Propofol, Fentanyl, Na Oxybate, Midaz. but no paralytics and I can use all. Propofol usually creates good conditions for intubation also without paralytics, but is very hypotensive. I like to combine Midazolam with propofol = less of hypotensive side efect. Edited May 26, 2012 by sihi Quote Link to comment Share on other sites More sharing options...
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