A comparative evaluation of I-gel and laryngeal mask airway supreme in laparoscopic surgeries: a randomized comparative study

Background: Supraglottic airway device results in less hemodynamic responses during laparoscopic surgery but supraglottic airway device to be used should have higher oropharyngeal seal pressure than peak pressure for effective ventilation as laparoscopic surgery also leads to higher airway pressure. In this study the efficiency of the I-gel with SLMA is compared in patients undergoing laparoscopic cholecystectomy surgeries.Methods: Sixty patients were randomized in to two groups, group A where I-gel was considered for airway management and group B where LMA Supreme was the device chosen for airway management.Results: Oropharyngeal seal pressure was significantly lower in group A than group B, 5 minutes after insertion of airway device it was 24.90±3.03 cm H2O and 27.30±3.41 cm H2O in group A and group B, respectively and 5 minutes after creation of pneumoperitoneum it was 25.53±3.17 cm H2O and 27.57±3.36 cm H2O in group A and group B, respectively. There was significant difference in the difference between inspiratory and expiratory tidal volume between the groups at all the time periods being higher in group A than group B. Hemodynamics were comparable between the two groups. Time taken to insert the airway device and Ryle’s tube insertion was significantly lesser in group B in comparison to group A. The percentage of complications was higher in group A than group B with no significant (p>0.05) association.Conclusions: Both the I-gel and SLMA devices can be used safely in laparoscopic cholecystectomy in non-obese patients. But in SLMA group oropharyngeal seal pressure was higher with lesser leak volume in comparison to I-gel group.

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Does body position, age, and heart rate induce IOP’s changes?

European Journal of Ophthalmology ◽

10.1177/11206721211023313 ◽

2021 ◽

pp. 112067212110233

Author(s):

Marcelina Sobczak ◽

Magdalena Asejczyk ◽

Malwina Geniusz

Keyword(s):

Heart Rate ◽

Body Position ◽

Age Groups ◽

Cardiovascular Parameters ◽

Entire Cohort ◽

Significant Difference ◽

Group A ◽

The Difference ◽

Group B ◽

Effect Of Age

Objectives: The main goal of this research was to determine the differences between the values of intraocular pressure (IOP) in the supine and sitting positions, and to assess the effect of age and cardiovascular parameters. Methods: Seventy-two healthy adults were enrolled and classified into age groups: 20–30 years (group A), 31–40 years (group B), and 41–71 years (group C). Corneal biometry and cardiovascular parameters, such as heart rate (HR), were measured. IOP measurements were taken in the sitting position (IOPS) and in the supine position (IOPL) using the iCare® Pro tonometer. Results: A significant difference between the IOPS and IOPL in the entire cohort was found ( p < 0.001). Regarding the age subgroups, a significant difference ( p < 0.001) between the IOPS and IOPL was obtained in group A (2.6 ± 1.6 mmHg) and group C (1.5 ± 1.3 mmHg). There were no significant differences in the IOPS between groups. The highest IOP values were obtained for group A. The correlations between HR and IOPS are statistically significant for group A and group B, and for HR and IOPL-S for group B only. Multivariate analysis showed that HR has a significant influence on the difference in IOP in the two body positions. Conclusion: A statistically significant difference between the effect of age and the values of IOPS and IOPL was shown. Cardiovascular parameters showed some relevant statistical dependencies, but with a rather marginal significance in young people. The influence of body position for the measurement of IOP for healthy subjects does not seem to matter, despite the fact that there are some dependencies that are statistically significant.

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To compare the frequency of postoperative sore throat with I-gel versus laryngeal mask airway in patients

10.53350/pjmhs2115123232 ◽

2021 ◽

Vol 15 (12) ◽

pp. 3232-3235

Author(s):

M. J. Ahmed Kamal ◽

Baber Zaheer ◽

Naveed Ahmed Durrani ◽

Khaleel Ahmad ◽

Sumara Tabassam ◽

...

Keyword(s):

Laryngeal Mask Airway ◽

General Anesthesia ◽

Sore Throat ◽

Laryngeal Mask ◽

Supraglottic Airway ◽

Postoperative Sore Throat ◽

Significant Difference ◽

Group A ◽

Group Members ◽

Group B

Background: In case of general anesthesia, airway maintenance along with least complications is the most important goal of team of anesthesiologists. In case of clinical practice, the laryngeal mask airway (LMA) devices have superiority in managing supraglottic airway. Recently i-gel airway has been introduced as supraglottic airway equipment (disposable). Aim: To make comparison between laryngeal mask and I-gel with respect to postoperative complication of sore throat in case of patients who were given general anesthesia. Study design: Randomized trial Setting: Anesthesia Department Study duration: 6 after synopsis approval in total 6months of duration Methods: Candidates were divided randomly divided into two groups. In case of members of group A, patients were given i-gel where as members of group B, disposable LMA was given. General anesthesia was administered according to the standardized protocols. A day after operation, candidates were check post operatively for 24 hours, for sore throat and information was documented on Performa. Results: The candidates mean age was 44.23±15.11years in case of i-gel group members whereas 46.10±15.56 years in case of LMA group. In case of i-gel group, there were about twenty five males members and thirty five were females members . In case of LMA group members, there were about twenty six males and thirty four female members . In present case research, sore throat postoperatively was seen in case of 17(14.2%) cases, i.e. 4 (6.7%) in i-gel group while 13(21.7%) in case of LMA group. The significant difference was witnessed between members of both groups (p<0.05). Conclusion: Thus i-gel is better than LMA for general anesthesia as it has fewer chances of side effects like postoperative sore throat. Keywords: Postoperative sore throat, I-gel, laryngeal mask airway, general anesthesia

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Effects of Dexmedetomidine on Intraoperative Hemodynamic Responses in Patients Undergoing Laparoscopic Cholecystectomy: A Randomised Double Blind Trial

Archives of Anesthesia and Critical Care ◽

10.18502/aacc.v7i4.7629 ◽

2021 ◽

Author(s):

Dhanashree Dongare ◽

Smita Gharde

Keyword(s):

Laparoscopic Cholecystectomy ◽

Base Line ◽

Loading Dose ◽

Double Blind Trial ◽

Hemodynamic Responses ◽

Double Blind ◽

Significant Difference ◽

Group A ◽

American Society ◽

Group B

Background: Dexmedetomidine is selective alpha 2 agonist with sedative sympatholytic, analgesic properties and is used as an anaesthetic adjuvant. We have evaluated the effect of dexmedetomidine on various hemodynamic responses to incidences such as laryngoscopy, endotracheal intubation, exubation and pneumoperitoneum in patients who were undergoing surgeries like laparoscopic cholecystectomy. We have used loading dose of 0.5mcg/kg of inj. Dexmedetomidine given over 10 minutes followed by infusion of a dose of 0.3mcg/kg/hour for the control of hemodynamic response to laparoscopy. Methods: Patient of either sex aged between 18-50 yrs, belongs to ASA I and II (AMERICAN SOCIETY OF ANAESTHESIOLOGY) posted for laparoscopic cholecystectomy were included. Institutional ethical committee clearance was obtained prior to study. After enrolment and valid written consent was taken. 60 patients were enrolled written valid informed consent was taken. Patients were divided into two groups 30 each with computerized randomization. Base line parameters were noted. Observer and patient was blinded for the content of syringe. Group A received injection dexmedetomidine and group B received bolus and infusion of normal saline at same rate. Routine general anaesthesia was instituted. Parameters were noted after induction, after intubation, after co2 insufflation, after 20 min, after 40 min, after co2 deflation, after extubation, after 1 and 2 hrs post-extubation. Results: Group A showed significantly less rise in HR and MAP than Group B. Requirement of intraoperative propofol was more in Group B. There was no significant difference for time taken to awakening in both groups. Conclusion: We found Injection Dexmedetomidine in given doses gave good hemodynamic control with minimal undesired effects during laparoscopy.

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The Efficacy and Safety of Nabufen and Sufentanil in the Prevention of Visceral Pain After Gynecological Laparoscopic Surgery: A Randomised Controlled Trial

10.21203/rs.3.rs-125287/v1 ◽

2020 ◽

Author(s):

Xiaoxia Gu ◽

Jingjing Wang ◽

Huihua Liao ◽

Jian Mo ◽

Weiming Huang ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Adverse Reactions ◽

Visceral Pain ◽

Sedation Score ◽

Efficacy And Safety ◽

Significant Difference ◽

Group A ◽

Group B ◽

Group D ◽

Ramsay Sedation Score

Abstract Background: To compare the efficacy and safety of different compatibility schemes in the prevention of visceral pain after gynecological laparoscopic surgery. Methods: from April 2019 to April 2020, patients undergoing elective gynecological laparoscopic surgery in our hospital were randomly divided into four groups: group A: sufentanil 3 μ g / kg; group B: low-dose nalbuphine group: 0.1 mg / kg of nabufen + 3 μ g / kg of sufentanil; group C: medium dose of nabufen group: 1 mg / kg of nabufen + 2 μ g / kg of sufentanil; group D: high-dose nabufen 2 There were 30 cases in each group. The degree of pain and the number of adverse reactions at 2, 4, 8, 12, 24 and 48 hours after operation were observed and recorded. The number and dosage of morphine used as a remedial analgesic were recorded. The pain degree was assessed by visual analogue scale (VAS). The total amount of analgesic pump used, the total number of times of pressing and the effective times of pressing were recorded. The adverse reactions included respiratory depression, nausea and vomiting, drowsiness, restlessness and skin The skin itches. Results: the analgesic effect of group B was similar to that of group A, and there was no significant difference in the number of invalid pressing, total pressing times and rescue analgesia rate (P > 0.05), while the invalid pressing times, total pressing times and remedial analgesia rate of group C and group D were significantly lower than those of group A (P < 0.05). There was no significant difference between group C and group D in the number of invalid compressions, the total number of compressions and the rate of remedial analgesia (P > 0.05), suggesting that increasing the dose of nalbuphine could not significantly increase the analgesic effect. The incidence of postoperative nausea and vomiting, skin pruritus, lethargy and Ramsay Sedation score in group B and group C were significantly lower than those in group A (P < 0.05). Ramsay Sedation score and incidence of drowsiness were lower than those in group D, which indicated that the incidence of adverse reactions was higher in group D than group B and group C.Conclusion: the combination of 1 mg / kg nabufen and 2 μ g / kg sufentanil is a safe and effective combination scheme for the prevention of visceral pain after gynecological laparoscopic surgery with small adverse reactions.Trial registration: http://www.chictr.org.cn/showproj.aspx?proj=40635Registration number：ChiCTR1900025076 . Prospectively registered on 10 August 2019.

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Role of a modified epigastric port in reducing post operative pain and causing early ambulation in a patient undergoing laparoscopic cholecystectomy as compared to a standard four port procedure, a randomized controlled study

International Surgery Journal ◽

10.18203/2349-2902.isj20205019 ◽

2020 ◽

Vol 7 (12) ◽

pp. 3986

Author(s):

Arijit Roy ◽

Pramatha Nath Datta ◽

Kushankur Guha

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Recovery ◽

Controlled Study ◽

Post Operative Pain ◽

Quality Life ◽

Significant Difference ◽

Group A ◽

Group B ◽

To Receive ◽

Better Than

Background: Standard four port laparoscopic cholecystectomy is the gold standard in the treatment of gall stones. Modified epigastric port laparoscopic cholecystectomy may be considered an alternative, as this procedure maintains the advantages of four ports and does not require any special set of instruments. In this study we aimed to see whether this procedure is comparable to the standard four port laparoscopic cholecystectomy based on the primary objectives of postoperative pain score, degree of ambulation, time to return to normal activities.Methods: Consecutive patients due to undergo laparoscopic cholecystectomy, meeting all the predefined criteria were recruited into the study. The group A was assigned to receive intervention in the form of modified epigastric port laparoscopic cholecystectomy. The group B was assigned to receive intervention in the form of standard four port laparoscopic cholecystectomy. Patients in group A were compared with patients in group B based on multiple pre-defined parameters.Results: Pain scores were significantly better in group A. Degree of ambulation at was significantly better in group A. In respect to the time to resumption of normal activities there was no significant difference between the two groups. When comparing the quality life at 1 month following surgery with SF-36 health survey, the patients in group A did better than patients in group B with respect to the six scales. Conclusions: Modified epigastric port laparoscopic cholecystectomy appears to be significantly better than the standard four port cholecystectomy in terms of postoperative recovery.

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Post operative nausea and vomiting after laparoscopic cholecystectomy: comparison of prophylactic effect of dexamethasone with ondansetron

Journal of the Bangladesh Society of Anaesthesiologists ◽

10.3329/jbsa.v24i2.19803 ◽

2014 ◽

Vol 24 (2) ◽

pp. 60-64

Author(s):

M Younus Ali ◽

Raihan Uddin ◽

Amirul Islam ◽

Mustafa Kamal ◽

SM Rafiqul Islam ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Nausea ◽

Vital Signs ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Group A ◽

The Difference ◽

Prophylactic Use ◽

Group B ◽

Post Operative Nausea

Background Postoperative nausea and vomiting after laparoscopic cholecystectomy under general anaesthesia are an unpleasant,distressing effects. Prophylactic use of dexamethesone reducing this effects. Objective This study was designed to compare of dexamethasone and ondansetron for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Methods Sixty patients who underwent laparoscopic cholesystectomy were randomly allocated into two groups. Group A(n=30) patients received 8mg dexamehtasone intravenously and Group B(n=30) patients received 8mg ondansetron intravenously one minute before induction of anaesthesia. All patients received standard general anaesthesia.Perioperative vital signs and postoperative nausea and vomiting were recorded. Results The incidence of nausea was 13.4% in group A, 16.7% in group B(p>0.05) and vomiting was 6.6% in Group A, 13.4% in group B(p>0.05). The difference among the groups was not statistically significant. Conclusion Intravenous dexamethasone was better to ondansetron in prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. DOI: http://dx.doi.org/10.3329/jbsa.v24i2.19803 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(2): 60-64

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ANTIBIOTIC PROPHYLAXIS IN LAPAROSCOPIC CHOLECISTECTOMY: IS IT WORTH DOING?

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-6720201600030010 ◽

2016 ◽

Vol 29 (3) ◽

pp. 170-172 ◽

Cited By ~ 5

Author(s):

Márcio Alexandre Terra PASSOS ◽

Pedro Eder PORTARI-FILHO

Keyword(s):

Laparoscopic Cholecystectomy ◽

Antibiotic Prophylaxis ◽

Infectious Complications ◽

Low Risk ◽

Double Blind Study ◽

Significant Difference ◽

Risk Patients ◽

Group A ◽

Elective Laparoscopic Cholecystectomy ◽

Group B

ABSTRACT Background: Elective laparoscopic cholecystectomy has very low risk for infectious complications, ranging the infection rate from 0.4% to 1.1%. Many surgeons still use routine antibiotic prophylaxis Aim: Evaluate the real impact of antibiotic prophylaxis in elective laparoscopic cholecystectomies in low risk patients. Method: Prospective, randomized and double-blind study. Were evaluated 100 patients that underwent elective laparoscopic cholecystectomy divided in two groups: group A (n=50), patients that received prophylaxis using intravenous Cephazolin (2 g) during anesthetic induction and group B (n=50), patients that didn't receive any antibiotic prophylaxis. The outcome evaluated were infeccious complications at surgical site. The patients were reviewed seven and 30 days after surgery. Results: There was incidence of 2% in infection complications in group A and 2% in group B. There was no statistical significant difference of infectious complications (p=0,05) between the groups. The groups were homogeneous and comparable. Conclusion: The use of the antibiotic prophylaxis in laparoscopic cholecystectomy in low risk patients doesn't provide any significant benefit in the decrease of surgical wound infection.

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Postoperative Sore Throat, Nausea and Vomiting in Routine Nasal Surgery: Influence of Pharyngeal Packing

Galen Medical Journal ◽

10.31661/gmj.v1i1.7 ◽

2012 ◽

Vol 1 (1) ◽

pp. 24-28

Author(s):

Mehrdad Naderian ◽

Ehsan Jangholi ◽

Taraneh Kharaz Tavakol

Keyword(s):

Sore Throat ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Control Group ◽

Nasal Surgery ◽

Significant Difference ◽

Group A ◽

The Difference ◽

Group B ◽

Pharyngeal Packing

Introduction: Pharyngeal packs are commonly used to prevent of postoperative nausea and vomiting (PONV) and Sore throat during nasal surgery following tracheal intubation. the aim of this study is evaluation of effectiveness of pharyngeal packing in the prevention of PONV. Materials and methods: This study with random sampling performed on 120 adult patients scheduled for routine nasal surgery referred Boo – Ali hospital in Tehran, Iran from March 2011 to March 2012. the study was approved in the ethical committee of Azad University and written informed consent to participate in the study. All subjects randomly allocated to Group A or Group B to have and not to have pharyngeal packing during surgery, Respectively.The incidence of PONV and sore throat in the recovery room,at 2 and 6 h were recorded by a 100 mm long visual analogue scale (VAS). Data were analysed using non-parametric tests in SPSS 18. Significant difference was set at p<0.05. Results: The average age of patients was 27.6 ± 7.1 years. The average of age in Group A was 29.2 ± 2.8 years and in Group B was 27.4 ± 3.2 years. The difference in throat pain scores in the two groups at each assessment time was statistically signiﬁcant. The difference in PONV scores were not statistically signiﬁcant. Conclusion: The usage of pharyngeal packing during nasal surgery leads to decreased incidence of sore throat in experiment group compared with the control group. Also has no effect on the incidence of PONV. [GMJ. 2012;1(1):24-28]

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COMPARISON OF ONDANSETRON AND METOCLOPRAMIDE IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY UNDER GENERAL ANESTHESIA.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.07.3825 ◽

2019 ◽

Vol 26 (07) ◽

pp. 1197-1202

Author(s):

Hajra Shuja ◽

Mehmood Ali Shah ◽

Sadaf Bokhari

Keyword(s):

Laparoscopic Cholecystectomy ◽

General Anesthesia ◽

Controlled Trial ◽

Study Groups ◽

P Value ◽

Significant Difference ◽

High Incidence ◽

Group A ◽

Group B ◽

Trial Setting

Background: Laparoscopic cholecystectomy is a standard treatment for cholelithiasis. It is a safe and effective treatment in many cases. General anesthesia has a high incidence for PONV. But anti-emetic drugs can help in preventing PONV. Objectives: To compare the efficacy of ondansetron and metoclopramide in patients undergoing laparoscopic cholecystectomy under general anesthesia. Study Design: Randomized controlled trial. Setting: Department of Anaesthesia, Sheikh Zayed Hospital, Lahore. Period: 6 months i.e. from 15-2-2017 to 15-8-2017. Material & Methods: The patients were divided into two groups. Ondansetron was given to group A patients within 15 minutes of induction, and metoclopramide to group B patients within 15 minutes of induction. Then patients were shifted to the ward after surgery and followed-up for 24 hours for assessment of PONV. All the data was entered and analyzed on SPSS version 20. Results: The mean age of patients in group A was 38.40±12.07 years and in group B was 42.63±11.77 years. The efficacy achieved in 53 were from group A and 39 were from group B Statistically significant difference was found between the study groups i.e. p-value=0.003. Conclusion: Ondansetron showed significantly better efficacy than metoclopramide in preventing PONV after laparoscopic cholecystectomy under general anesthesia.

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The influence of balanced complex chromosomal rearrangements on preimplantation embryonic development potential and molecular karyotype

10.21203/rs.2.14678/v4 ◽

2020 ◽

Author(s):

Gang Li ◽

Weiyi Shi ◽

Wenbin Niu ◽

Jiawei Xu ◽

Yihong Guo ◽

...

Keyword(s):

Embryonic Development ◽

High Quality ◽

Preimplantation Genetic Testing ◽

Abnormal Embryo ◽

Significant Difference ◽

Molecular Karyotype ◽

Group A ◽

The Difference ◽

Group B ◽

Euploid Embryo

Abstract Background: Balanced complex chromosome rearrangements (BCCR) are balanced chromosomal structural aberrations that involve two or more chromosomes and at least three breakpoints. It is very rare in the population.The objective is to explore the difference of influence of three types of BCCR on early embryonic development and molecular karyotype.Results:Twelve couples were recruited including four couples of three-way rearrangements carriers (group A), three couples of double two-way translocations carriers (group B) and five couples of exceptional CCR carriers (group C). A total of 243 oocytes were retrievedin the seventeen preimplantation genetic testing (PGT) cycles, and 207 of these were available for fertilization.After intracytoplasmic sperm injection, 181oocytes normally fertilized. The rates of embryos forming on day3 in three groups were 87.88%, 97.78% and77.14%, which was significantly different (P=0.01). Compared with group B, the rate of embryo formation was statistically significantly lower in group C(P=0.01).Furthermore, the rates of high-quality blastocysts in three group were 14.71%, 48.15% and 62.96%, respectively, which was significantly different (P=0.00). Compared with group B andC, the rate of high-quality blastocysts in group A was statistically significantly lower (P=0.00;P=0.00). Comprehensive chromosome analysis was performed on 83 embryos, including 75 trophectodermcellsand 8 blastomeres. Except 7 embryos failed to amplify, 9.01%embryos were diagnosed as euploidy, and 90.91% were diagnosed as abnormal. As for group A, the euploid embryo rate was 10.71%and the abnormal embryo rate was 89.29%. In group B,the euploid embryo rate was 3.85%, the abnormal embryo rate was 96.15%. The euploid embryo rate was 13.04%, the abnormal embryo rate was 86.96% in group C.There were no significant differences among the three groups (P = 0.55).Conclusions:The lowest rate of high quality blastocysts has been for three-way rearrangements and the lowest rate of euploidy has been for double two-way translocations, although no significant difference. Different types of BCCR maybe have little effect on the embryonic molecular karyotype. The difference of influence of BCCR on early embryonic developmentandmolecular karyotypeshould be further studied.

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