Steroids post extubation stridor

a) Amiodarone

This is a powerful drug for the control of atrial and ventricular arrhythmias.

The dosage regime is as follows (via a central line):-

300 mgs in 100mls 5 % Dextrose over 1 hour
then 900 mgs in 250 mls 5% Dextrose over 23 hours

The initial oral dose is then 200 mgs tds for 1 week reduced thereafter to bd followed by maintenance od.

( Note. Some has a preference not to use this agent first line and prefers Digoxin)

b) Cardioversion

A DC shock applied to the chest is an effective way of restoring sinus rhythm, particularly supraventricular tachycardia. This is usually carried out by the Cardiologist.

3. Ventricular Arrhythmias

VF\VT - See cardiac arrest

Peripheral Nerve Block: May be performed for both proximal and distal tendon rupture repairs. For proximal surgeries (ie, shoulder), various approaches may be used: interscalene, supraclavicular (with possible supplementation of C3-4 blockade for cape area), suprascapular nerve block, combination of axillary and suprascapular nerve blocks. Similarly, a variety of alternatives exists for management of distal surgeries; interscalene, supraclavicular, infraclavicular and axillary. Single shot nerve blocks or perineural catheters may be used for both proximal as well as distal surgeries. Regional anesthesia may be used as the primary anesthetic (preferably with sedation) or combined with general anesthesia.

  1. Benefits:
    1. § Avoid potential GA complications: such as trauma to lips, teeth, pharynx or vocal cords; bronchospasm; aspiration; prolonged somnolence; prolonged paralysis from atypical response to NMB; malignant hyperthermia

      Steroids post extubation stridor

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