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 ◽  
Dongxu Yao ◽  
Jixiu Xue ◽  
Tianlong Wang
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Laryngeal Mask Airway ◽  
Effective Dose ◽  
General Anaesthesia ◽  
Laryngeal Mask ◽  
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 and hypnotic median effective dose of cis- atracurium using a sequential method for successful laryngeal mask insertion when inducting general anaesthesia. Method s : The cohort study protocol is registered at clinicaltrial.gov (NCT-03358680). Twenty-three patients undergoing elective urinary surgery were sequentially administered doses (mg·kg -1 ) of cis- atracurium as follows: 0.15, 0.1, 0.07, 0.05, 0.03, and 0.02. Systolic and diastolic blood pressure, heart rate, bispectral index, and train-of-four were continuously monitored. Successful laryngeal mask insertion occurred without resistance to mouth opening, resistance to insertion, coughing, swallowing, laryngospasm/airway obstruction, and head and body movement. 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. Result s : The median effective dose of cis- atracurium was 0.0265 mg·kg -1 (95% CI 0.0236-0.0298) using the sequential method. The heart rate was decreased in the 0.05 group compared to the 0.03 group at timepoints T7, T8, and T10. The systolic blood pressure was decreased in the 0.02 group compared to the 0.05 group at timepoints T2, T3, T4. The train-of-four value was significantly lower in the 0.05 group than in the 0.03 group at timepoint T3. Conclusion s : cis- a tracurium was a good option for muscle relaxation in urinary surgery.

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 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. Methods : 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. Results : 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). Conclusions : The ED50 of cis- atracurium was 26.5 μg·kg -1 for laryngeal mask airway insertion.

AN OBSERVATIONAL STUDY TO EVALUATE THE HAEMODYNAMIC CHANGES BETWEEN ENDOTRACHEAL INTUBATION AND LARYNGEAL MASK AIRWAY INSERTION

2021 ◽  
pp. 56-58
Author(s):  
Rahul Kumar ◽  
Anant Prakash ◽  
Chandeshwar Choudhary ◽  
Debarshi Jana
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Laryngeal Mask Airway ◽  
Observational Study ◽  
Arterial Pressure ◽  
Airway Management ◽  
Endotracheal Intubation ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion

Introduction: Airway management is a crucial skill for the clinical anaesthesiologist. It is an integral part of general anesthesia, allowing ventilation and oxygenation as well as a mode for anesthetic gas delivery. The laryngeal mask airways (LMA) have become popular in airway management as a missing link between facemask and tracheal tube in terms of both anatomical position and degree of invasiveness. Haemodynamic stability is an important aspect to the anaesthesiologist for the benet of the patients especially during intubations, laryngeal mask insertion. Laryngoscopy and endotracheal intubation can cause striking changes in Haemodynamics as result of intense stimulation of sympathetic nervous system. The aim of this study was to evaluate the hemodynamic changes between endotracheal intubation and laryngeal mask airway insertion. Material And Methods: This was a prospective observational study on 46 patients of ASA I-II status divided into 2 groups of 23 each. In the ETT (Endotracheal tube) group endotracheal intubation was done using Macintosh laryngoscope by using portex cuffed endotracheal while in LMA (Laryngeal mask airway) group laryngeal mask airway was inserted according to the standard recommendation. Heart rate, Systolic, Diastolic and Mean arterial pressure and dysrhythmias were monitored. Results: The two groups were comparable in terms of demographic data as there were no signicant differences between the 2 groups in terms of age, sex, duration of surgery, ASA grades and MPC classication. Heart rate (HR), Systolic blood pressure (SBP), Diastolic blood pressure(DBP), Mean arterial pressure (MAP) remains on higher side in ETT group than LMA group which was statistically signicant. P<0.05. Dysrhythmias were noted in 2 patients of ETT group while LMA group did not notice any dysrhythmias. Conclusion: This study demonstrated that there is a haemodynamic response consisting of an increase in Heart rate, SBP, DBP and MAP that comes with ETT insertion as well as with LMA insertion. However, the response caused by ETT insertion is signicantly greater than that caused by LMA insertion.

scholarly journals Haemodynamic Changes at Induction during Laryngeal Mask Airway Insertion: Comparison of Propofol Versus Lignocaine-Thiopentone Admixture

2020 ◽  
Vol 3 (4) ◽  
pp. 422-429
Author(s):  
SI Nuhu ◽  
GA Ajogwu ◽  
HY Embu ◽  
FD Atteh ◽  
DU Orshio ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Laryngeal Mask Airway ◽  
Drug Administration ◽  
Laryngeal Mask ◽  
Baseline Heart Rate ◽  
Laryngeal Mask Airway Insertion ◽  
Randomised Study ◽  
Post Induction ◽  
Haemodynamic Changes

To determine the haemodynamic changes at induction during laryngeal mask airway (LMA) insertion comparing propofol versus lignocaine-thiopentone admixture. In this comparative randomised study, patients of American Society of Anesthesiologists’ (ASA) class I and II with age range of 18-60 years scheduled for short elective surgeries were randomly assigned into two equal groups. Patients were premedicated with fentanyl 1ug.kg-1. Anaesthesia was induced with either 2.5mg.kg-1 propofol or a sequence of 2mg.kg-1 lignocaine and 5mg.kg-1 thiopental given by a trained assistance. Anaesthesia was maintained with 2% isoflurane and 100% oxygen. Haemodynamic variables [Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) and Heart Rate (HR)] were measured non-invasively in three periods; before drug administration, immediately after drug administration prior to insertion of LMA and finally after LMA insertion.In group A, the baseline heart rate (92.3±11) was compared to the post-induction heart rate (100.7±09) with p=0.765 and post-insertion heart rate (98.0±13) with p=0.767. Although, there was a rise in the heart rate from the baseline after induction and insertion of LMA, this was not statistically significant. Also, baseline SBP (120.7±09) was compared to the post-induction SBP (102.5±07) with p=0.001 and post-insertion SBP (102.59±07) with p=0.001. This was statistically significant. The baseline DBP (77.9±08) was compared to the post-induction DBP (67.0±12) with p=0.004 and post-insertion DBP (62.5±09) with p=0.001.This was statistically significant. The baseline MAP (92.6±01) was compared to the post-induction MAP (79.7±01) with p=0.008 and post-insertion MAP (76.2±07) with p=0.001. This was also statistically significant. In group B, the baseline heart rate (93.2±12) was compared to post-induction heart rate (99.2±11) with p=0.520 and post-insertion heart rate (94.8±12) with p=0.989. This was not statistically significant. The baseline SBP (120.7±13) was compared to the post-induction SBP (115.9±12) with p=0.139 and post-insertion SBP (117.5±13) with p=0.318. This was not statistically significant. The baseline DBP (80.6±14) was compared to the post-induction DBP (75.2±11) with p=0.636 and post-insertion DBP (76.6±13) with p=0.712. This was also not statistically significant. The baseline MAP (94.3±01) was compared to the post-induction MAP (87.5±01) with p=0.779 and post-insertion MAP (88.3±01) with p=0.882. This was not statistically significant. We concluded that propofol and lignocaine-thiopentone admixture exhibited similar haemodynamic profile in our study and therefore recommend that both drugs can be used for patients.

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

scholarly journals Randomized clinical trial of trapezius squeezing test and jaw thrust as optimal indicators for Laryngeal mask airway insertion in adults under propofol anesthesia

2016 ◽  
Vol 3 (2) ◽  
pp. 64-68 ◽  
Author(s):  
Sushil Khanal ◽  
Bibhush Shrestha ◽  
Roshana Amatya ◽  
Moda Nath Marhatta
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Laryngeal Mask Airway ◽  
Randomized Study ◽  
Laryngeal Mask ◽  
P Value ◽  
Laryngeal Mask Airway Insertion ◽  
Unsuccessful Attempt ◽  
Arterial Blood ◽  
Adequate Condition

Background: Laryngeal mask airway insertion requires a certain depth of anesthesia that blunts the airway reflexes. We compared the effectiveness of the trapezius squeezing test with that of the jaw thrust test as clinical indicators of adequate condition for laryngeal mask airway insertion in adults under propofol anesthesia.Methods: In this randomized study, seventy adult patients undergoing surgery with general anesthesia maintained with laryngeal mask airway were randomly allocated to the group T (trapezius squeezing, n = 35) or the group J (jaw thrust, n = 35). The laryngeal mask airway was inserted immediately after the loss of response to trapezius squeezing or jaw thrust.  We recorded successful and unsuccessful attempts. An unsuccessful attempt was defined as development of coughing, SPO2 < 90%, body movements during or within one minute of laryngeal mask airway insertion and failed insertion of laryngeal mask airway. Preparation time for laryngeal mask airway insertion, blood pressure, and heart rate were recorded.Results: The incidence of successful attempts was significantly higher in the group T than in the group J (p-value = 0.002). The time taken for preparation and insertion of laryngeal mask airway, arterial blood pressure and heart rate were comparable in both the groups.Conclusion: This study has demonstrated that the trapezius squeezing test is a superior indicator of an adequate condition for laryngeal mask airway insertion compared to the jaw thrust test in adults.

The median effective dose of dexmedetomidine for laryngeal mask airway insertion with propofol 2.0 mg/kg

2014 ◽  
Vol 58 (7) ◽  
pp. 815-819 ◽  
Author(s):  
H. J. KWAK ◽  
S. K. MIN ◽  
J. Y. YOO ◽  
K. H. PARK ◽  
J. Y. KIM
Keyword(s):  
Laryngeal Mask Airway ◽  
Effective Dose ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion

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

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