Haemodynamic changes with the laryngeal mask airway - off the cuff

1997 ◽  
Vol 14 (5) ◽  
pp. 514-517
Author(s):  
S. Colbert ◽  
D. M. O'Hanlon ◽  
R. Page ◽  
F. Flanagan ◽  
D. Moriarty
Keyword(s):  
Laryngeal Mask Airway ◽  
Laryngeal Mask ◽  
Haemodynamic Changes

scholarly journals Comparative Study of Propofol Versus Thiopental Sodium with Succinylcholine for Laryngeal Mask Airway (LMA) Insertion

2018 ◽  
Vol 10 (1) ◽  
pp. 11-15
Author(s):  
Chandra Shekhar Karmakar ◽  
Md Afzalur Rahman ◽  
Mohammad Rezaul Karim ◽  
Monirul Islam ◽  
Md Shahidul Islam ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Low Dose ◽  
Upper Airway ◽  
Laryngeal Mask ◽  
Airway Reflex ◽  
Haemodynamic Changes ◽  
Thiopental Sodium ◽  
Group 2 ◽  
Insertion Condition ◽  
Group 1

Background: The increasing emphasis on day case anaesthesia has lead to the greater use of the laryngeal mask airway (LMA) as an alternative to intubation. Laryngoscopy and tracheal intubation are noxious stimuli, which cause a reflex increase in both sympathetic and sympathoadrenal activity that may result in tachycardia, hypertension and dysarrhythmias. Insertion of Laryngeal mask airway (LMA) is associated with less haemodynamic changes, minimal increase in intraocular and intracranial pressure and lower incidence of sore throat. Still its insertion requires sufficient depth of anesthesia to prevent airway reflex (gagging, coughing nd spasms). To insert LMA successfully propofol is the most frequently administered medication. But most of all recommend not using propofol singly for LMA insertion. Thiopental can’t suppress the upper airway reflexes as propofol but with low dose succinylcholine upper airway reflexes are attenuated so combination of thiopental sodium with succinylcholine may be another choice of drug.Objectives: This Prospective study was conducted to evaluate the effectiveness of Thiopental sodium and Succinylcholine for insertion of the LMA in comparison with Propofol.Methods: This interventional study was carried out in Sixty patients, aged 3-45 years who were scheduled for elective surgical procedure under general anaesthesia in ShSMCH. Patients were randomly assigned to two groups by odd and even number basis. In Group-1 (N1=30), LMA was inserted after induction with Thiopental sodium (5 mg/kg body weight i.v.) and Succinylcholine (0.5mg/kg i.v); in Group-2 (N2 = 30), the LMA was inserted with Propofol (2.5mg/kg i.v). Jaw relaxation, incidence of coughing- gagging , overall insertion condition and haemodynamic changes were observed.Results: Grade of jaw relaxation in Group-1 was Good in 93.3%, incomplete in 6.7% and 0% poor but in Group-2, 86.7% was good 10% incomplete and 3.3% was poor. Coughing occurred in 33.3% of patients in the Group-2 and there was only 10% in succinyl group (P=0.028) which is significantly higher in Group-2. Overall insertion condition in Group -1 was excellent in 86.7%, Good in 10% cases and poor in only 3.3% cases on the other hand in Group-2 excellent in 53.3%, Good in 33.3% cases and poor in only 13.3% cases (P=0.019).Conclusion: There was statistically significant difference in jaw relaxation in two groups and incidence of Gagging or Coughing is higher in Group-2. Overall insertion condition was significantly better in Group-1. We concluded that Thiopental sodium with low dose Suxamethonium is an effective alternative of Propofol.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 11-15

Haemodynamic changes with the laryngeal mask airway - off the cuff

1997 ◽  
Vol 14 (5) ◽  
pp. 514-517 ◽  
Author(s):  
S. Colbert ◽  
D. M. O'Hanlon ◽  
R. Page ◽  
F. Flanagan ◽  
D. Moriarty
Keyword(s):  
Laryngeal Mask Airway ◽  
Laryngeal Mask ◽  
Haemodynamic Changes

scholarly journals Comparison of haemodynamic alteration with laryngeal mask airway and endotracheal tube in intermediate duration of gynaecological operation

2014 ◽  
Vol 23 (2) ◽  
pp. 51-55
Author(s):  
Azizul Gafur ◽  
Mustafa Kamal ◽  
Ashia Alia ◽  
Idris Ali ◽  
Amirul Islam ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Sympathetic Nerves ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion ◽  
Exclusion Criteria ◽  
Haemodynamic Parameters ◽  
Haemodynamic Changes ◽  
Group A ◽  
Group B ◽  
System Objective

Background Laryngeal mask airway insertion causes less changes of haemodynamic parameters. As haemodynamic changes during laryngoscopy and endotracheal intubation as result of intense stimulation of sympathetic nerves system. Objective To find out the effective airway management by LMA during controlled ventilation, to avoid laryngoscopic and intubation induced haemodynamic changes and to avoid laryngospasm and bronchospasm. Method A total number of 100 patients ASA grade I & II were selected randomly as per inclusion and exclusion criteria in two groups. Fifty in each group. In group A used LMA and in group B used ETT during general anaesthesia in intermediate duration of gynaecological operation. Pulse,NIBP,SpO2 were recorded in perioperatively. Result Pulse, blood pressure were significant between the two groups (p<0.00) but in SpO2 was insignificant except in 2 min of intraoperative which was significant. (p<0.013). Conclusion LMA insertion causes less changes of haemodynamic parameters when compared with that of ET intubation. Our finding suggests that LMA can be safe and beneficial alternative to ETT. DOI: http://dx.doi.org/10.3329/jbsa.v23i2.18174 Journal of BSA, 2009; 23(2): 51-55

scholarly journals Comparative evaluation of induction with propofol vs induction with sevoflurane for insertion of laryngeal mask airway in children

2019 ◽  
Vol 7 (4) ◽  
pp. 1271
Author(s):  
Sandhya A. Bakshi ◽  
Sanjay S. Bule ◽  
Ganesh U. Shingade
Keyword(s):  
Laryngeal Mask Airway ◽  
Cost Effective ◽  
Perioperative Period ◽  
Laryngeal Mask ◽  
Induction Agent ◽  
Airway Injury ◽  
Cost Effective Method ◽  
Haemodynamic Changes ◽  
Pleasant Odour ◽  
Time Required

Background: There is increasing use of laryngeal mask airway in children because of ease of insertion and minimal disturbances in cardio respiratory system and lesser risk of airway injury during perioperative period as compared to endotracheal tube. It is also simple, well-tolerated, safe, reusable, cost effective method of airway management in paediatric patients. Intravenous propofol (1%) is a preferred induction agent for LMA insertion till date, while sevoflurane, a halogenated volatile inhalational, non-irritating anaesthetist agent with pleasant odour is also suitable for inhalational induction of children. This study was carried out to study and compare clinical efficacy of propofol and sevoflurane for laryngeal mask airway (LMA) insertion in children undergoing short surgical procedures.Methods: In this study, total 100 children of ASA grade I/II of either sex with age group 3-8 years, weighing between 10-20 kg were enrolled. They were induced with either sevoflurane (group S) or intravenous propofol (group P) 3 mg/kg. Then appropriate size LMA was inserted. Various parameters like jaw relaxation and ease of insertion attempts required hemodynamic changes were noted and compared in two groups.Results: In group P, 94% patients and groups S, 90% patients had full jaw relaxation. The LMA insertion was easy in 98% patients in groups P and 94% patients in groups S. In 98% patients of groups P and 96% patients in groups S, LMA was inserted successfully in first attempt. The mean time required for LMA insertion was 19.16±5.29 seconds in groups P and 20.8±6.39 seconds in groups S. Both the groups were comparable with respect to haemodynamic changes observed which were transient and clinically not significant though statically significant.Conclusions: Both the groups showed comparable and satisfactory LMA insertion conditions, hence both can be routinely used for induction of anaesthesia in children.

scholarly journals Intravenous Propofol and Inhalational Sevoflurane for Ease of Classic Laryngeal Mask Airway Insertion in Patients Undergoing Elective Surgery: A Randomised Clinical Trial

2021 ◽  
Author(s):  
Nilanjan Chakraborty ◽  
Prosenjit Mukherjee ◽  
Rita Pal
Keyword(s):  
Clinical Trial ◽  
Laryngeal Mask Airway ◽  
Induction Time ◽  
Elective Surgery ◽  
Randomised Clinical Trial ◽  
Laryngeal Mask ◽  
Insertion Time ◽  
P Value ◽  
Induction Agent ◽  
Haemodynamic Changes

Introduction: The Laryngeal Mask Airway (LMA) has gained extensive popularity for airway management during surgery. Propofol, the most commonly used induction agent for LMA insertion, causes significant haemodynamic changes. Sevoflurane has the potential to be as good an induction agent as propofol. Aim: To compare ease of insertion of classic LMA in patients undergoing elective surgery using intravenous propofol and inhalational sevoflurane. Materials and Methods: The study was a randomised clinical trial conducted in the Operation Theatres of Midnapur Medical College and Hospital, Medinipur, West Bengal, India, from August 2019 to July 2020. Eighty patients of American Society of Anaesthesiologists (ASA) physical status grade I and II, of both sexes, and aged between 18 years to 65 years were equally divided into two groups: group P (Propofol group) and group S (Sevoflurane group). Group P was given injection Propofol 2.5 mg/kg body weight and group S was given vital capacity breath induction with 8% sevoflurane and oxygen at 8 litres/min. Loss of Consciousness (LOC) was confirmed and induction time was noted for each group. After confirmation of ease of mouth opening, by an independent observer, LMA insertion was attempted. Ease of LMA insertion was assessed by a predefined 18 points table along with time to LMA insertion and number of attempts. Haemodynamic changes and adverse effects were also recorded. Chi-square test or Student’s t-test were used and a p-value ≤0.05 was considered as statistically significant. Results: With respect to age, sex and weight there were no significant differences between the two groups. Induction time was significantly less in group P (51.85±6.66 seconds) compared to group S (68.38±13.93 seconds) (p-value=0.0001), but LMA insertion time, number of attempts and overall ease of LMA insertion conditions according to the 18 points score were comparable between the two groups. Mean arterial pressure at certain points after induction was significantly less in group P (at 3 minute p-value=0.009 and at 5 minute p-value=0.007). Apnea was significantly more in group P (p-value=0.023). Conclusion: Sevoflurane was comparable to propofol for LMA insertion in respect of ease of insertion and insertion time. Although induction time was significantly less for propofol, sevoflurane offered better haemodynamic stability and lesser incidence of apnea.

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