scholarly journals The Incidence of Bacteraemia following Laryngeal Mask Insertion

1992 ◽  
Vol 20 (4) ◽  
pp. 484-486 ◽  
Author(s):  
J. Brimacombe ◽  
N. Shorney ◽  
R. Swainston ◽  
G. Bapty
Keyword(s):  
Laryngeal Mask Airway ◽  
Antibiotic Prophylaxis ◽  
Laryngeal Mask ◽  
The Other ◽  
Anaerobic Culture ◽  
Culture Bottle ◽  
Oral Intubation ◽  
Skin Flora ◽  
Laryngeal Mask Insertion

The incidence of bacteraemia following insertion of the laryngeal mask airway (LMA) was investigated in one hundred fit patients. Four cultures were positive: three represented contamination with skin flora; the other was a microaerophilic streptococcus grown from an anaerobic culture bottle. Although this organism can be pathogenic, it may also represent contamination. Our findings suggest that significant bacteraemia on insertion of the LMA is uncommon and is probably no more than with oral intubation. Antibiotic prophylaxis is of doubtful benefit in these circumstances.

scholarly journals Comparison of efficacy of propofol and sevoflurane for laryngeal mask airway insertion during elective surgeries

2015 ◽  
Vol 5 (1) ◽  
pp. 23-27
Author(s):  
H R Rehman ◽  
I Hassan ◽  
T Hussain ◽  
A A Mir ◽  
M Zahid
Keyword(s):  
Laryngeal Mask Airway ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion ◽  
Cough Reflex ◽  
Laryngeal Mask Insertion ◽  
Group A ◽  
Gag Reflex ◽  
The Difference ◽  
Hospital Ethics ◽  
Group B

This study was conducted in the Department of Anesthesiology, Holy Family Hospital Rawalpindi from 5 October 2011 to 5 April 2012 after approval of hospital ethics committee. Three hundred and eighteen patients fulfilling the inclusion criteria were selected in the study by non-probability consecutive sampling after taking informed written consent. Patients between the ages of 20 to 40 years were included, belonging to ASA class I and II, requiring General Anesthesia with Laryngeal Mask Airway for different surgical procedures. They were divided into two equal groups by computer generated random numbers. Group A comprised of one hundred and fifty eight patients in whom intravenous propofol was given for induction of anesthesia and Laryngeal mask insertion. Group B comprised of one hundred and fifty eight patients in whom inhalational induction with sevoflurane was done for Laryngeal mask insertion. Conduct of anesthesia was maintained similar in both groups. Cough and gag reflexes were observed in both groups at the time of Laryngeal mask insertion. Drug under study was said to be effective, if it is associated with no cough and gag reflex during Laryngeal mask insertion. All the data was analyzed by SPSS version 15. It was observed that 6.3% patients of group A (propofol) had positive cough reflex as compare to 13.2%% patients of group B (sevoflurane). The difference was statistically significant (p=0.038). While the incidence of gag reflex in group A was 8.2% and group B was 14.5%. But the difference was not found to be statistically significant (p=0.077). Propofol is more effective than sevoflurane for smooth LMA insertion during elective surgeries.DOI: http://dx.doi.org/10.3126/jcmc.v5i1.12562

scholarly journals Propofol Induction for Laryngeal Mask Airway Insertion: Dose Requirement and Cardiorespiratory Effects

1992 ◽  
Vol 20 (4) ◽  
pp. 479-483 ◽  
Author(s):  
D. W. Blake ◽  
P. Dawson ◽  
G. Donnan ◽  
A. Bjorksten
Keyword(s):  
Plasma Concentration ◽  
Laryngeal Mask Airway ◽  
Cardiovascular Effects ◽  
Laryngeal Mask ◽  
The Other ◽  
Laryngeal Mask Airway Insertion ◽  
Dose Requirement ◽  
Respiratory Effects

The dosage, haemodynamic and respiratory effects of propofol for laryngeal mask airway (LMA) insertion were investigated. Fifty patients (ASA I-II) were randomly assigned one of four induction doses of propofol (1.5–2.5 mg/kg) delivered over 30 seconds and the first attempt at LMA insertion was made at 90 seconds. The LMA was inserted at 90 seconds in 35 patients and by 300 seconds in 13 others (mean plasma concentration at 90 seconds was 7.7 mcg/ml (no delay) versus 5.2 mcg/ml (insertion delayed), P < 0.01). Insertion was less successful after 1.5 mcg/kg (failed at 90 seconds in 6 of 12 patients), but did not vary with the other doses. Additional propofol (0.5 mg/kg/30s) was required in 22 patients for LMA insertion or to prevent movement, resulting in propofol concentrations at 120–180 seconds above 7 mcg/ml. Respiratory effects were minor, but MAP decreased by 18±1.4 mmHg at 90 seconds. Cardiovascular effects did not differ significantly between dosage groups or with the use of additional propofol.

scholarly journals The Median Effective Dose (ED50) of cis-Atracurium for Laryngeal Mask Airway Insertion during General Anaesthesia for Patients Undergoing Urinary Surgery

2019 ◽  
Author(s):  
Xiaohua Wang ◽  
Ke Huang ◽  
Hao Yan ◽  
Fei Lan ◽  
Dongxu Yao ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Effective Dose ◽  
Optimal Dose ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Laryngeal Mask Airway Insertion ◽  
Sequential Method ◽  
Laryngeal Mask Insertion ◽  
Train Of Four

Abstract Background In clinical practice, the laryngeal mask airway is an easy-to-use supraglottic airway device. However, the cis- atracurium dosage for laryngeal mask insertion is not standardised. We aimed to determine the optimal dose of cis- atracurium using a sequential method for successful laryngeal mask insertion. Method s : The cohort study protocol is registered at clinicaltrial.gov (NCT-03668262). Twenty-three patients undergoing elective urinary surgery were sequentially administered doses (μg· kg -1 ) of cis- atracurium as follows: 150, 100, 70, 50, 30, and 20. The main outcome was the response to laryngeal mask airway insertion: ≥16 points and <16 points indicated “satisfactory” and “unsatisfactory” responses, respectively. The median effective dose was estimated using the mean of the seven crossovers from “satisfactory” and “unsatisfactory” responses. The primary outcome was to determine the median effective dose (ED50) of cis- atracurium for laryngeal mask airway insertion. Result s : The median effective dose of cis- atracurium was 26.5 μg·kg -1 (95% CI 23.6-29.8) using the sequential method. The heart rate was decreased in the 50μg·kg -1 group compared to the 30μg·kg -1 group at timepoints T7, T8, and T10 ( P = 0.0482, P = 0.0460, and P = 0.0236, respectively), but no difference with 20 μg·kg -1 group. The systolic blood pressure was decreased in the 50 μg·kg -1 group compared to the 20 μg·kg -1 group at timepoints T2, T3, T4 ( P = 0.0159, P = 0.0233, and P = 0.0428, respectively). The train-of-four value was significantly lower in the 50 μg·kg -1 group than in the 30 μg·kg -1 group at timepoint T3( P = 0.0326). Conclusion s : The ED50 of cis- atracurium was 26.5 μg·kg -1 for laryngeal mask airway insertion.

scholarly journals The Median Effective Dose (ED50) of cis-Atracurium for Laryngeal Mask Airway Insertion during General Anaesthesia for Patients Undergoing Urinary Surgery

2020 ◽  
Author(s):  
Xiaohua Wang ◽  
Ke Huang ◽  
Hao Yan ◽  
Fei Lan ◽  
Dongxu Yao ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Effective Dose ◽  
Optimal Dose ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Laryngeal Mask Airway Insertion ◽  
Sequential Method ◽  
Laryngeal Mask Insertion ◽  
Train Of Four

Abstract Background In clinical practice, the laryngeal mask airway is an easy-to-use supraglottic airway device. However, the cis- atracurium dosage for laryngeal mask insertion is not standardised. We aimed to determine the optimal dose of cis- atracurium using a sequential method for successful laryngeal mask insertion. Method s : The cohort study protocol is registered at clinicaltrial.gov (NCT-03668262). Twenty-three patients undergoing elective urinary surgery were sequentially administered doses (μg· kg -1 ) of cis- atracurium as follows: 150, 100, 70, 50, 30, and 20. The main outcome was the response to laryngeal mask airway insertion: ≥16 points and <16 points indicated “satisfactory” and “unsatisfactory” responses, respectively. The median effective dose was estimated using the mean of the seven crossovers from “satisfactory” and “unsatisfactory” responses. The primary outcome was to determine the median effective dose (ED50) of cis- atracurium for laryngeal mask airway insertion. Result s : The median effective dose of cis- atracurium was 26.5 μg·kg -1 (95% CI 23.6-29.8) using the sequential method. The heart rate was decreased in the 50μg·kg -1 group compared to the 30μg·kg -1 group at timepoints T7, T8, and T10 ( P = 0.0482, P = 0.0460, and P = 0.0236, respectively), but no difference with 20 μg·kg -1 group. The systolic blood pressure was decreased in the 50 μg·kg -1 group compared to the 20 μg·kg -1 group at timepoints T2, T3, T4 ( P = 0.0159, P = 0.0233, and P = 0.0428, respectively). The train-of-four value was significantly lower in the 50 μg·kg -1 group than in the 30 μg·kg -1 group at timepoint T3( P = 0.0326). Conclusion s : The ED50 of cis- atracurium was 26.5 μg·kg -1 for laryngeal mask airway insertion.

scholarly journals Supreme™ laryngeal mask airway insertion requires a lower concentration of sevoflurane than ProSeal™ laryngeal mask airway insertion during target-controlled remifentanil infusion: a prospective randomised controlled study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cristina Monteserín-Matesanz ◽  
Tatiana González ◽  
María José Anadón-Baselga ◽  
Matilde Zaballos
Keyword(s):  
Laryngeal Mask Airway ◽  
Confidence Interval ◽  
Laryngeal Mask ◽  
Controlled Study ◽  
Laryngeal Mask Airway Insertion ◽  
Remifentanil Infusion ◽  
Sevoflurane Concentration ◽  
Obstructive Sleep ◽  
Laryngeal Mask Insertion ◽  
End Tidal

Abstract Background ProSeal (PLMA) and Supreme (SLMA) laryngeal mask airways are effective ventilator devices with distinctive designs that may require different anaesthetics for insertion. Sevoflurane induction provides acceptable conditions for laryngeal mask insertion, and remifentanil significantly decreases the minimum alveolar concentration of sevoflurane required for that insertion. The study aimed to evaluate the optimal end-tidal (ET) sevoflurane concentration for successful insertion of PLMA versus SLMA in patients receiving a remifentanil infusion without a neuromuscular blocking agent. Methods Altogether, 45 patients ASA (American Society Anaesthesiologists) physical status I–II, aged 18–60 years were scheduled for elective ambulatory surgery. Exclusion criteria were a difficult airway, recent respiratory infection, reactive airway, obstructive sleep apnoea syndrome, gastric aspiration’s risk factors, pregnancy, and lactation. Patients were randomly allocated to receive the SLMA or the PLMA. Sevoflurane induction with co-administration of remifentanil was performed at an effect-site concentration of 4 ng mL− 1. ET50 was calculated with a modified Dixon’s up-and-down method (starting at 2.5% in steps of 0.5%). Predetermined sevoflurane concentration was kept constant during the 10 min before LMA insertion. Patient’s response to LMA insertion was classified as “movement” or “no movement”. Sevoflurane ET50 was determined as the midpoint concentration of all the independent pairs that manifested crossover from “movement” to “no movement”. Results The ET50 sevoflurane concentration co-administered with remifentanil required for PLMA insertion was 1.20 ± 0.41% (95% confidence interval 0.76 to 1.63%). For SLMA insertion, it was 0.55 ± 0.38% (95% confidence interval 0.14 to 0.95%) (p = 0.019). Conclusions The end-tidal sevoflurane concentration with co-administered remifentanil required to allow insertion of the SLMA was 54% lower than that needed for inserting the PLMA. Trial registration Clinicaltrials.gov identifier: NCT03003377. Retrospectively registered. Date of registration: December 28, 2016.

Alfentanil Dosage When Inserting the Classic Laryngeal Mask Airway

2006 ◽  
Vol 105 (4) ◽  
pp. 684-688 ◽  
Author(s):  
Andrea L. Y. Yu ◽  
Lester A. H. Critchley ◽  
Anna Lee ◽  
Tony Gin
Keyword(s):  
Laryngeal Mask Airway ◽  
Confidence Intervals ◽  
Mouth Opening ◽  
Study Drug ◽  
Probit Analysis ◽  
Laryngeal Mask ◽  
Chinese Patients ◽  
Optimum Dose ◽  
Laryngeal Mask Insertion ◽  
Classic Laryngeal Mask Airway

Background The purpose of this study was to determine an optimum dose of alfentanil, coadministered with 2.5 mg/kg propofol, when inserting a classic laryngeal mask airway. Methods Seventy-five adult ethnic Chinese patients with an American Society of Anesthesiologists physiologic status classification I or II and requiring anesthesia for minor surgery with a laryngeal mask were recruited. They were randomly assigned to five dosage groups: placebo or 5, 10, 15, or 20 microg/kg. The study drug plus propofol were administered, and 90 s later, insertion conditions were assessed using a six-category score. The duration of apnea was recorded. A probit analysis was performed and used to estimate the ED50 and ED95 with 95% confidence intervals for each assessment. Results Twenty-five male and 50 female patients, aged 18-59 yr, were studied. The five groups were similar. Laryngeal mask insertion was successful in all but one alfentanil patient. Duration of apnea increased with increasing dosage of alfentanil to over 5 min (P &lt; 0.001). Dose-responses could not be predicted for categories of resistance to mouth opening and to insertion. For the other four categories, swallowing, gagging, movement, and laryngospasm, ED50 and ED95 with confidence intervals for alfentanil could be determined. Conclusion The optimum dose for alfentanil, when coadministered with 2.5 mg/kg propofol, was 10 microg/kg.

scholarly journals Pulmonary Aspiration of Blood following Traumatic Laryngeal Mask Airway Insertion

1998 ◽  
Vol 26 (2) ◽  
pp. 213-215 ◽  
Author(s):  
A. Norton ◽  
J. Germonpré ◽  
T. Semple
Keyword(s):  
Laryngeal Mask Airway ◽  
Upper Airway ◽  
Pulmonary Aspiration ◽  
Laryngeal Mask ◽  
Lower Airway ◽  
Laryngeal Mask Airway Insertion ◽  
Common Event ◽  
Laryngeal Mask Insertion ◽  
Life Threatening ◽  
Life Threatening Complication

An unusual and potentially life-threatening complication arising from a relatively common event—bleeding due to traumatic laryngeal mask insertion—is presented. It demonstrates that the laryngeal mask airway (LMA) cannot always be relied upon to protect the lower airway from upper airway bleeding.

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