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Abstract
Maxillofacial and major neck surgeries have a considerable risk for postoperative laryngo-pharyngeal oedema and airway obstruction due to surgical manipulation or haematoma. Patients may require reintubation after they have been extubated; reintubation may be very difficult or impossible through laryngoscopy because of the characteristics of these operations such as mandibular fixation with an archbar or as a result of anatomical changes result in considerable morbidity and mortality.
The frequent occurrence of cardiovascular reactions to tracheal extubation has attracted the attention of anaesthetists for many years ago.
The aim of the present study was to determine the usefulness of routinely inserting the endotracheal tube exchange catheter (ETEC) before extubation of adult patients undergoing major maxillofacial or neck surgery, and to compare between the effect of lidocaine and verapamil in attenuation of the hemodynamic changes during
The present study was carried out on thirty adult patients of either sex, physical status ASA class I, II, admitted to the department of maxillofacial surgery, Alexandria Main University hospital, scheduled for major maxillofacial surgery, whose airway expected to be difficult after operation, and planed to be extubated over endotracheal tube exchange catheter. Patients were randomly allocated into two groups, fifteen patients each by closed envelop method.
In both groups anaesthesia was induced with intravenous fentanyl 1µg /kg, propofol 2 mg/kg, and pancuronium 0.1 mg/kg to facilitate endotracheal intubation. After endotracheal intubation, anaesthesia was