scholarly journals Frequency of excellent Laryngeal mask airway insertion conditions in children undergoing elective surgery: A comparison of propofol with ketofol.

2020 ◽  
Vol 27 (03) ◽  
pp. 607-612
Author(s):  
Humaira Ahmad ◽  
Amna Tariq ◽  
Asif Sagheer ◽  
Aisha Ahmad ◽  
Samina Aslam
Keyword(s):  
Laryngeal Mask Airway ◽  
Elective Surgery ◽  
Muscle Relaxation ◽  
Laryngeal Mask ◽  
Ethical Review ◽  
P Value ◽  
Induction Agent ◽  
Laryngeal Mask Airway Insertion ◽  
Study Evaluation ◽  
Trial Setting

Objectives: The laryngeal mask airway is used for provision of anesthesia for various surgical procedures as well as in emergency management of airway. It is a useful rescue tool in cases of failed intubation. Its insertion is associated with lesser complications. With advancement in medical equipment new versions of LMA with additional benefits are available. In this study evaluation of frequency of excellent LMA insertion conditions with use of ketofol or propofol as induction agent has to be evaluated. Purpose of the study is to identify which agent will provide favourable conditions for insertion, with least complications. Study Design: Randomized control trial. Setting: Departments of Anesthesia and Intensive Care Allied Hospital and Aziz Fatimah Hospital, Faisalabad. Period: From 01-01-2017 to 30-06-2018. Material & Methods: Approval from ethical review committee was obtained. 230 children presenting for elective surgery were enrolled into study using non-probability consecutive sampling. Two groups consisting of 115 each were generated by randomization. Group P received propofol and Group PK received 2:1 propofol ketamine mixture. Ease of LMA insertion was assessed on the basis of degree of muscle relaxation and adverse reactions to LMA insertion. Data was collected and analysed using SPSS version 18. Results: Results were presented in terms of frequency of excellent LMA insertion conditions. It showed that ketofol provides better LMA insertion as compared to propofol alone with p value of 0.007, which is significant. Conclusion: The study concluded that use of ketofol provides excellent insertion conditions for LMA insertion in children presenting for elective surgery.

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.

LARYNGEAL MASK AIRWAY PLACEMENT: A COMPARISON BETWEEN PROPOFOL AND THIOPENTONE SODIUM IN THE DAY CASE SURGERY

1970 ◽  
Vol 6 (4) ◽  
pp. 31-35
Author(s):  
Yasmeen Afridi ◽  
Naheed Fatima ◽  
Suresh Kumar ◽  
Khawaja Kamal Nasir
Keyword(s):  
Laryngeal Mask Airway ◽  
Management Practice ◽  
Laryngeal Mask ◽  
P Value ◽  
Induction Agent ◽  
Day Case ◽  
Cross Sectional ◽  
Thiopentone Sodium ◽  
Group A ◽  
Group B

BACKGROUND: Laryngeal Mask Airway (LMA) placement is now considered a common airway management practice. Although there are many studies which focus on various airway techniques, research regarding difficult LMA placement is limited, particularly for anesthesiologist trainees OBJECTIVE: To assess the effectiveness of Laryngeal Mask Airway (LMA) placement after induction with propofol or thiopentone in one hundred day case urological patients. METHODS: An analytical, non interventional, cross sectional comparative study. Patients were divided into Group A (Propofol Group n=50) received propofol (2.5mg/kg) and Group B (Thiopentone group n=50) received thiopentone sodium (4-6 mg/kg) IV. Management of anaesthesia was identical in both groups. Standard monitoring was including NIBP, pulse oxymetery and ECG was done. Co-induction with done with midazolam 0.1 mg/kg body weight. LMA was inserted after adequate level of anaesthesia and then assessed. The presence of gaging, coughing, laryngospasm and movement were noted , recorded by a colleague anaesthetist who entered the induction room during the two minutes assisted ventilation phase and was not aware of the type of induction agent. Statistical analysis was done by using SPSS version 10. The mean and standard deviation was calculated for age. Frequency of subjects was calculated for gender Lund and stovner assessment scheme. The p value of less than 0.05 was considered significant. RESULTS: Thiopentone was associated with an adverse response in 76% of patients, compared with propofol in 26% (p<0.01). Head movement, Laryngospasm, inadequate jaw relaxation were more common using thiopentone (p<0.05). The quality of anaesthesia according to patients was significantly higher in the propofol group (Group A, 80%) than in thiopentone group (Group B, 30%). CONCLUSION: Adverse responses in Group A were less than Group B. Propofol, therefore is superior to thiopentone as an induction agent for laryngeal mask airway.

scholarly journals Ease of Proseal Laryngeal Mask Airway Insertion and its Fibreoptic view after Placement using Gum Elastic Bougie: A Comparison with Conventional Techniques

2009 ◽  
Vol 37 (3) ◽  
pp. 435-440 ◽  
Author(s):  
S. Taneja ◽  
M. Agarwal ◽  
J. S. Dali ◽  
G. Agrawal
Keyword(s):  
Laryngeal Mask Airway ◽  
Elective Surgery ◽  
Lateral Approach ◽  
Proseal Laryngeal Mask Airway ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion ◽  
Digital Technique ◽  
Number Of Patients ◽  
Airway Tube ◽  
Induction Of Anaesthesia

The Proseal Laryngeal Mask Airway (PLMA) is routinely inserted by the digital and introducer tool techniques but a newer Gum Elastic Bougie (GEB) guided insertion technique has been described. The aims and objectives were to compare the ease of PLMA insertion and fibreoptic view of PLMA after placement using GEB and conventional techniques. Ninety-six ASA I or II patients of either gender, aged 18 to 60 years, scheduled for elective surgery under general anaesthesia in the supine position were included in this study. Following induction of anaesthesia, a PLMA was inserted using a GEB, introducer tool or digital technique in Groups G, I and D respectively (n=32). Correct placement of the PLMA was confirmed by using clinical tests along with fibreoptic assessment. Ease of PLMA insertion was assessed by the number of attempts, time taken and number of patients requiring lateral approach for insertion. The fibreoptic view of PLMA placement through the airway tube was graded on a scale from 4 (best view) to 1 (worst view). GEB-guided PLMA insertion was more successful both after the first attempt (G 100%, I 69%, D 72%, P <0.01) and after two attempts (G 100%, I 78%, D 84%, P <0.05). Time taken for successful placement was significantly shorter in the GEB-guided group after two attempts (G 22∓2 seconds, I 31.9±18.8 seconds, D 29.5±18.6 seconds, P <0.05). The fibreoptic view through the airway tube was significantly better in the GEB-guided group (P <0.01). Incidence of trauma was significantly less in the GEB-guided group (P <0.05).

scholarly journals Laryngeal mask airway insertion by classic and thumb insertion technique: a comparison

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 123 ◽  
Author(s):  
Monica Goyal ◽  
Akanksha Dutt ◽  
Anjum S Khan Joad
Keyword(s):  
Laryngeal Mask Airway ◽  
Index Finger ◽  
Elective Surgery ◽  
Study Groups ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion ◽  
Insertion Technique ◽  
Group I ◽  
American Society ◽  
American Society Of Anesthesiologists

We evaluated the efficacy of an alternative technique, for insertion of the silicone laryngeal mask airway (LMA) Classic™ in 40 American Society of Anesthesiologists grade ASA I and II patients scheduled for elective surgery. In group I (Index Finger group), the LMA was inserted by the classic index finger technique and, in group T (Thumb Insertion group), the thumb insertion technique was used. Ease of insertion, fiberoptic laryngoscopic position, cuff pressures and laryngopharyngeal morbidity were assessed in both study groups. On statistical analysis, both groups were comparable in all respects. From our study it can be concluded that thumb insertion is an effective insertion technique for the LMA Classic™.

scholarly journals Study to assess the effect of mini-dose Succinylcholine for ease of laryngeal mask airway insertion

2019 ◽  
Vol 7 (6) ◽  
pp. 2089
Author(s):  
Megha P. Tajne ◽  
Heena D. Pahuja ◽  
Lalit K. Rathi ◽  
Aditi Bhatnagar ◽  
Amitkumar H. Belokar
Keyword(s):  
Sodium Chloride ◽  
Laryngeal Mask Airway ◽  
Small Sample ◽  
Laryngeal Mask ◽  
Control Group ◽  
Induction Agent ◽  
Laryngeal Mask Airway Insertion ◽  
Hemodynamic Parameters ◽  
Significant Difference ◽  
Grade 3

Background: Propofol as sole induction agent is often insufficient for the laryngeal mask airway insertion and higher doses are at times required. The present study proposes to assess the effectiveness of 0.25mg/kg mini dose succinylcholine towards facilitation of laryngeal mask airway (LMA) insertion.Methods: In a single blinded randomized controlled trial, 68 patients posted for elective general and orthopaedic surgery were equally assigned to two groups during LMA insertion: Group S (Study group)- patients received a bolus of succinylcholine 0.25mg/kg diluted in 2 ml of 0.9% sodium chloride. Group C (Control group)-patients received a bolus dose of 2 ml of 0.9% sodium chloride. The number of attempts required and ease of LMA insertion, hemodynamic parameters and adverse responses were noted and compared between the groups.Results: The LMA was inserted in first attempt in 32 (94.11%) patients in group S and in 24 (70.58%) patients in group C. The control group had 67.62% grade 1, 32.38% grade 2 and 0% grade 3, while succinylcholine group had 73.53% grade 1, 26.47% grade 2 and 0% grade 3. Hemodynamic parameters didn’t differ significantly between the two groups at any point, but significant difference was observed between occurrence of fasciculation, head and limb movements, sore throat and coughing.Conclusions: Succinylcholine does seem to help in insertion of the laryngeal mask airway but the results could not gain the level of statistical significance, partly attributed to small sample size.

scholarly journals Assessment of Efficacy of Dexmedetomidine and Fentanyl in Combination with Propofol for Ease of Laryngeal Mask Airway Insertion and Haemodynamic Stability

2020 ◽  
pp. 55-58
Author(s):  
Kankudte Akshay O ◽  
Sunil S Lawhale
Keyword(s):  
Blood Pressure ◽  
Laryngeal Mask Airway ◽  
Elective Surgery ◽  
Statistical Significance ◽  
Young Patients ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion ◽  
Haemodynamic Stability ◽  
Optimal Drug ◽  
The Individual

Background: Laryngeal mask airway (LMA) insertion requires anesthesia and suppression of airway reflexes. In search of an optimal drug, we compared dexmedetomidine and fentanyl, in combination with Propofol for ease of LMA insertion and haemodynamic stability. Method: Total 120 patients belonging to ASA status I & II posted for elective surgery were randomly divided into 2 equal groups. Both the groups received I.V glycopyrrolate 4μg/kg prior to receiving the study drugs. Group D received dexmedetomidine I.V 1μg/kg diluted in 10cc NS over 10min while group F received fentanyl I.V 2μg/kg diluted in 10cc NS over 10min. Induction was done with IV Propofol 2mg/kg in both the groups. After 90 sec, LMA insertion (no 3 for females and no.4 for males) was done by the consultant anaesthesiologist blinded to the technique. Results: Jaw opening, ease of LMA insertion, requirement of additional Propofol was clinically insignificant and comparable between two groups. Cough though seen more in fentanyl group, (p=0.042) while the incidence of bradycardia was more with dexmedetomidine group. Between the two groups, the change in blood pressure from baseline to 30sec after induction and upto 10min after LMA insertion was statistically insignificant. Within the individual groups, the changes in the blood pressure reached statistical significance. These changes did not reach a clinical significance and required no additional medication. Conclusion: Either dexmedetomidine or fentanyl when used along with propofol provides comparable conditions for the ease of LMA insertion with stable haemodynamic parameters in pre-hydrated, healthy and young patients.

Sign in / Sign up

Export Citation Format

Share Document