scholarly journals Comparative evaluation of topical and intravenous lignocaine for insertion of laryngeal mask airway with propofol

2018 ◽  
Vol 5 (3) ◽  
pp. 573
Author(s):  
Saba Ahmed ◽  
Namrata Jain ◽  
Sanjay Saksena
Keyword(s):  
Heart Rate ◽  
Laryngeal Mask Airway ◽  
Comparative Evaluation ◽  
Laryngeal Mask ◽  
Age Group ◽  
Group 16 ◽  
Group 2 ◽  
Group 1

Background: Objective of present study to determine that administration of Intravenous Lignocaine prior to propofol is as effective as topically on the posterior oropharynx for LMA insertion.Methods: 60 patients of age group 16-45years of both sexes, ASA Grade I and II undergoing elective surgeries. Group 1: (n=30) Patients receiving Lignocaine 1.5 mg/kg IV over 30 seconds. Group 2: (n=30) Patients receiving lignocaine aerosol 40 mg topically. Conditions of LMA insertion, gagging laryngospasm ,coughing noted at time of insertion, ECG, NIBP, SPO2 and ETCO2 were recorded according to scheduled times.Results: In Conditions of insertion, difference between groups reached significance, p<0.05. In groups at first min, rise in heart rate, fall in DSP, SBP and MAP was significant. At two and three minutes post LMA insertion these parameters change slightly but statistically not significant.Conclusions: Topical Lignocaine 10% aerosol prior to propofol induction provides excellent conditions for LMA insertion without the use of neuromuscular blockages.

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

scholarly journals A Comparative Study of Laryngeal Mask Airway and Air-Q Intubating Laryngeal Airway Using Parker Flex Tip Tube

2020 ◽  
Vol 5 (1) ◽  
pp. 149-152
Author(s):  
Sanjay Melville Masih ◽  
Rakesh Kumar Gupta
Keyword(s):  
Laryngeal Mask Airway ◽  
Endotracheal Intubation ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Intubating Laryngeal Mask Airway ◽  
Study Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: To facilitate tracheal intubation, intubating laryngeal mask airway(ILMA) was designed specifically. A relatively new supraglottic airway device, air-Q ILA is an alternative to ILMA to facilitate endotracheal intubation. Considering advantages of air-Q over ILMA are that the breathing tube of the device is shorter, wider and due to removable connector, a standard e Parker Flex Tip tracheal tube (product of Parker Medical Company) has a curved, centered, flexible and tapered distal tip that is designed to facilitate easy, rapid and non-traumatic intubation. It has double murphy eyes with an anterior curvature and a posterior opening bevel. It is designed so that the posterior bevel will decrease the incidence of the tube catching at the anterior or the lateral laryngeal structures during tracheal intubation.Subjects and Methods: This is a randomized, single-blind study. Total of 100 patients of either sex aged 18–60 years belonging to American Society of Anaesthesiologists (ASA) physical status I or II scheduled for elective surgery under general anesthesia with endotracheal intubation were included in the study and the patients with respiratory or pharyngeal pathology, mouth opening < 2.5 cm, body mass index ≥35 kg/m2, pregnancy and anticipated difficult airway were excluded from the study. The duration of the study was one year. The ethical clearance was taken from the institutional ethical committee. Written informed consent from all participants was obtained for participation in the study. Results: A total of 100 patients were allocated for the study. The insertion of the airway device was successful in all the patients of group 1. So, 50  patients were analysed for intubation in group 1. Air-Q ILA could not be inserted and resulted in failure in two cases. Hence, 48 patients were analysed statistically for intubation in group 2. The two groups were comparable with respect to age, weight and sex distribution. The mean age of patients in group 1 was 40.00 ± 10.76 years and in group 2 it was 40.56 ± 11.0 years (P = 0.651). There were 30 females and 20 males both in group 1 and group 2 (P = 1.000). The mean weight of patients in group 1 was 60.34 ± 8.06 kg and in group 2 was 60.10 ± 10.05 kg (P = 0.924). Conclusion:The  overall success rate using Parker Flex Tip tube was more with ILMA (99%) as compared to air-Q ILA (78%). It can be further suggested that Parker Flex Tip tube can be used as an alternative to silicone tube with ILMA, but more multicentre studies are required over larger populations to evaluate the utility of Parker Flex Tip tube with air-Q ILA.

scholarly journals Comparative Evaluation of Topical Lignocaine Versus Intravenous Lignocaine for Laryngeal Mask Airway Insertion in Wardha, Maharashtra

2021 ◽  
Vol 10 (28) ◽  
pp. 2078-2082
Author(s):  
Swathi Reddy G. ◽  
Karuna Taksande
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Laryngeal Mask Airway ◽  
Arterial Pressure ◽  
Comparative Evaluation ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion ◽  
Hemodynamic Parameters ◽  
Group I

BACKGROUND The purpose of present study was to compare and evaluate both topical lignocaine and intravenous lignocaine for laryngeal mask airway (LMA) insertion prior to propofol. Main objective was to study the conditions for LMA insertion with respect to gagging, coughing, Laryngospasm and No. of attempts for LMA insertion and also study the hemodynamic parameters in both the groups (Heart rate, SBP,DBP, MAP, SpO2) METHODS This study included 60 patients of 30 in each group, ASA I & II day care surgeries were performed in our hospital between 2019 and 2021. Patients were randomized into two groups. Group I received intravenous lignocaine 1.5 mg / kg over 30 seconds and group II received topical lignocaine 40 mg. Conditions of LMA insertion, gagging, laryngospasm, coughing were noted at the time of insertion, ECG, NIBP, SPO2 and ETCO2 were recorded according to scheduled times. RESULTS In conditions of LMA insertion, difference between both the groups was found to be significant, P < 0.05 in groups with first minute rise in heart rate, fall in Systolic blood pressure, diastolic blood pressure, mean arterial pressure was significant. At two minutes and three minutes after the LMA insertion, HR, SBP, DBP, MAP all these parameters changed slightly but these changes were statistically not significant. CONCLUSIONS Prior to Propofol induction, compared to intravenous lignocaine, topical lignocaine 10 % aerosol provided excellent conditions for the insertion of LMA without the use of neuromuscular blockers. KEY WORDS IV Lignocaine, Topical Lignocaine, LMA

Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Proff ◽  
B Merkely ◽  
R Papp ◽  
C Lenz ◽  
P.J Nordbeck ◽  
...  
Keyword(s):  
Heart Rate ◽  
Closed Loop ◽  
Funding Source ◽  
Chronotropic Incompetence ◽  
First Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI. Purpose This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients. Methods A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL. Results Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13). Conclusion First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG

scholarly journals Sociodemographic Predictors of Physical Functioning in the Elderly: A National Health Survey

2018 ◽  
Vol 16 (1) ◽  
pp. 37
Author(s):  
Milena Kostadinovic ◽  
Dejan Nikolic ◽  
Ivana Petronic ◽  
Dragana Cirovic ◽  
Mirko Grajic ◽  
...  
Keyword(s):  
Marital Status ◽  
Educational Level ◽  
Well Being ◽  
Population Based ◽  
Age Group ◽  
Place Of Residence ◽  
Gender Group ◽  
Group 2 ◽  
Level Group ◽  
Group 1

We aimed to evaluate the prevalence of sociodemographic factors with the presence and different degrees of walking difficulties in elderly above 65 years, and to analyze association between evaluated variables and the presence and degree of waking difficulties. In the population based study, 3540 individuals age above 65 years from Serbia were recruited. Further predictors were analyzed: gender, age, level of education, marital status, body mass index (BMI), index of well-being and place of residence. We assessed difficulty in walking half a km on level ground without the use of any aid (Group-1); and difficulty in walking up or down 12 steps (Group-2). Walking difficulties were categorized as no difficulty, some difficulty, a lot of difficulty and cannot do at all. For present difficulty significant predictors were: age (Group-1 (OR-3.022)/Group-2 (OR-3.825)), gender (Group-1 (OR-0.337)/Group-2 (OR-0.311)), educational level (Group-1 (OR-0.689)/Group-2 (OR-0.556)) and place of residence (Group-2 (OR-1.523)) while for non-performing the task, significant predictors were: age (Group-1 (OR-1.998)/Group-2 (OR-2.096)), gender (Group-1 (OR-0.629)/Group-2 (OR-0.495)), BMI (Group-1 (OR-1.219)/Group-2 (OR-1.305)), marital status (Group-1 (OR 0.764)/Group-2 (OR-0.769)), educational level (Group-1 (OR-0.679)/Group-2 (OR-0.719)) and index of well-being (Group-2 (OR-0.764)). Understanding of predictors, and their role on functional decline in elderly is of great importance for the development of specific population-based health programs to prevent further functional loss and preserve achieved functional gains.

Neonatal Neurobehavior in the First 48 Hours of Life: Effect of the Administration of Meperidine With and Without Naloxone in the Mother

PEDIATRICS ◽  
1978 ◽  
Vol 62 (3) ◽  
pp. 294-298 ◽  
Author(s):  
Robert Hodgkinson ◽  
M. Bhatt ◽  
G. Grewal ◽  
G. F. Marx
Keyword(s):  
Age Group ◽  
Naloxone Hydrochloride ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The early neonatal neurobehavioral scale ‘was administered to three groups of newborns at 2, 4, and 24 hours of age. Group 1 consisted of 28 babies whose mothers had received no narcotics during labor, group 2 of 33 babies whose mothers had received meperidine hydrochloride alone during labor, and group 3 of 40 babies whose mothers had received meperidine followed by 0.4 mg of naloxone hydrochloride intravenously approximately 15 minutes before delivery. Babies who were not exposed to meperidine showed a statistically significantly greater percentage of high scores than those exposed to meperidine alone for all items on the neurobehavioral scale at 2 and 4 hours and for all items except tone and Moro response at 24 hours. Similarly, babies whose mothers had received meperidine and naloxone showed a significantly greater percentage of high scores than those whose mothers had received meperidine alone at 2 hours of age. At 4 hours a difference was found for tone and rooting and at 24 hours for overall score, placing, and total decrement score. It is concluded that naloxone given intravenously to the mother reverses the effect of meperidine on neonatal neurobehavior for approximately two hours after birth. At 4 and 24 hours, however, the neurobehavior of neonates exposed to meperidine and naloxone is depressed almost as much as that of babies exposed to meperidine alone.

scholarly journals COMPARATIVE EVALUATION OF SAFETY AND IMMUNOGENICITY INACTIVATED VACCINE FOR POLYOMIELITIS PREVENTION (NETHERLANDS) AND VACCINE «IMOVAX POLIO» (FRANCE) IN CHILDREN USING TRIPLE IMMUNIZATION

2019 ◽  
Vol 1 (3) ◽  
pp. 53-60
Author(s):  
I. V. Feldblyum ◽  
V. V. Romanenko ◽  
M. G. Menshikova ◽  
I. A. Okuneva ◽  
A. E. Makarov ◽  
...  
Keyword(s):  
Russian Federation ◽  
Multicenter Study ◽  
Safety Profile ◽  
Comparative Evaluation ◽  
Vaccination Schedule ◽  
Inactivated Vaccine ◽  
Poliomyelitis Vaccine ◽  
The Russian Federation ◽  
Group 2 ◽  
Group 1

Aim is comparative evaluation of the safety and immunogenicity of inactivated poliomyelitis vaccine (IPV) «Bilthoven Biologicals B.V.» (Netherlands) and «Imovax Polio» (France) with subcutaneous and intramuscular modes of administration. Materials and methods. In a doubleblind, comparative clinical randomized multicenter study, 120 children at the age of 3 months participated as volunteers. They were divided into 4 groups: 1 and 2 groups were given IPV intramuscular (group 1) and subcutaneous (group 2) mode of administration, children of groups 3 and 4 were given the vaccine «Imovax Polio». Results. IPV is characterized by a high safety profile and immunogenicity both in subcutaneous and intramuscular modes of administration and it is comparable in its characteristics with the vaccine «Imovax Polio». Conclusion. Vaccine IPV (Netherlands) is recommended for registration in the territory of the Russian Federation and its further using in the National Vaccination Schedule.

scholarly journals Possibilities of cardioselective beta - blocker bisoprolol therapy in patients having coronary artery disease and bronchial asthma

2019 ◽  
Vol 91 (9) ◽  
pp. 26-31
Author(s):  
N Y Grigorieva ◽  
T P Ilyushina ◽  
E M Yashina
Keyword(s):  
Coronary Artery Disease ◽  
Heart Rate ◽  
Coronary Artery ◽  
Calcium Antagonist ◽  
Beta Blocker ◽  
Ventricular Extrasystoles ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Aim: to compare the antianginal and pulse slowing effects, the impact on the ectopic myocardial activity as well as the safety of the treatment with beta - adrenoblocker bisoprolol, calcium antagonist verapamil and the combination of bisoprolol with amlodipine in patients with stable angina (SA) and bronchial asthma (BA). Materials and methods. The study included 90 patients with SA II-III functional class (FC) having concomitant persistent asthma of moderate severity, controlled, without exacerbation. The patients were divided into three groups with 30 individuals in each one depending on the main antianginal drug prescribed. Group 1 patients received a cardio - selective beta - adrenergic blocker bisoprolol (Concor) at the dose of 5 mg/day, patients of group 2 were treated by a calcium antagonist verapamil at the dose of 240 mg/day, patients of group 3 received combined therapy with bisoprolol at the dose of 5 mg/day and amlodipine at the dose of 5 mg/day given as a fixed combination (Concor AM 5/5). All the patients were investigated by the methods of daily ECG monitoring and respiratory function study (RFS) in addition to physical examination at baseline and after 4 weeks of treatment. Results. After 4 weeks of treatment, patients of group 1 and group 3 did not complain of angina attacks and did not use nitroglycerin unlike patients of group 2. The achieved heart rate (HR) in group 1 patients was 68.6±8.5 beats/min, in group 2 - 74.3±5.6 beats/min, in group 3 - 67.3±4.8 beats/min. A significant decrease in the number of supraventricular and ventricular extrasystoles occurred in patients of group 1 and group 3 only. Thus, the pulse slowing, antianginal, antiischemic and antiarrhythmic effect of the calcium antagonist verapamil, even at the dose of 240 mg/day, is not always sufficient for the patients with SA II-III FC and concomitant BA, unlike therapy with the inclusion of beta - blocker bisoprolol. During the study there was no registered deterioration in the indices of bronchial patency according to the RFS data in the patients of all three groups. Conclusion. In patients with coronary artery disease and concomitant asthma, all three types of pulse slowing therapy do not have any negative effects on bronchial patency. Therapy with the inclusion of beta - blockers (bisoprolol or its combination with amlodipine), in contrast to verapamil, reliably reduces heart rate and the number of supraventricular and ventricular extrasystoles in addition to a good antianginal effect.

scholarly journals Medial plantar nerve: normative parameters of an electroneuromyographic study in adults

2021 ◽  
Vol 11 (2) ◽  
pp. 28-34
Author(s):  
D. A. Grishina ◽  
N. A. Suponeva
Keyword(s):  
Statistical Analysis ◽  
Healthy Subjects ◽  
Tibial Nerve ◽  
Age Group ◽  
Research Practice ◽  
Healthy Individuals ◽  
Medial Plantar Nerve ◽  
Comparative Statistical Analysis ◽  
Group 2 ◽  
Group 1

Background. The study of the sensitive portion of the medial plantar nerve is relevant not only in the examination of patients with tibial nerve mononeuropathy or its branches, but also in the diagnosis of polyneuropathies.Objective: to analyze the normative parameters of the sensory potential recorded during the study of the medial plantar nerve by the orthodromic method in healthy adults.Materials and methods. 126 sensitive fibers of the medial plantar nerves were studied on the Dantec Keypoint G4 device (Denmark) in 63 healthy individuals (31 men and 32 women; age from 20 to 80 years). 3 groups were identified taking into account age: group 1 included healthy people aged 20 to 39 years (n = 23); group 2 consisted of people aged 40 to 60 years (n = 20); and 3 – older than 60 years (n = 20). The parameters of the sensory potential of the medial plantar nerve are analyzed.Results. The sensory potential in the study of the sensitive portion of the medial plantar nerve was registered in all 126 healthy subjects. Comparative statistical analysis did not demonstrate significant differences between groups 1–3 in the values of such parameters of the sensory potential as the latency of the onset, the duration of the negative phase and the rate of propagation of excitation. At the same time, in groups 2 and 3, the magnitude of the amplitude from peak to peak of the sensory potential was significantly lower compared to group 1, and averaged 8.92 and 7.86 MV, respectively.Conclusion. Knowledge of the regulatory parameters will allow expanding the use of electroneuromyography of the sensitive portion of the medial plantar nerve in clinical and research practice.

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