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 Comparison of haemodynamic alteration with laryngeal mask airway and endotracheal tube in intermediate duration of gynaecological operation

2014 ◽  
Vol 23 (2) ◽  
pp. 51-55
Author(s):  
Azizul Gafur ◽  
Mustafa Kamal ◽  
Ashia Alia ◽  
Idris Ali ◽  
Amirul Islam ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Sympathetic Nerves ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion ◽  
Exclusion Criteria ◽  
Haemodynamic Parameters ◽  
Haemodynamic Changes ◽  
Group A ◽  
Group B ◽  
System Objective

Background Laryngeal mask airway insertion causes less changes of haemodynamic parameters. As haemodynamic changes during laryngoscopy and endotracheal intubation as result of intense stimulation of sympathetic nerves system. Objective To find out the effective airway management by LMA during controlled ventilation, to avoid laryngoscopic and intubation induced haemodynamic changes and to avoid laryngospasm and bronchospasm. Method A total number of 100 patients ASA grade I & II were selected randomly as per inclusion and exclusion criteria in two groups. Fifty in each group. In group A used LMA and in group B used ETT during general anaesthesia in intermediate duration of gynaecological operation. Pulse,NIBP,SpO2 were recorded in perioperatively. Result Pulse, blood pressure were significant between the two groups (p<0.00) but in SpO2 was insignificant except in 2 min of intraoperative which was significant. (p<0.013). Conclusion LMA insertion causes less changes of haemodynamic parameters when compared with that of ET intubation. Our finding suggests that LMA can be safe and beneficial alternative to ETT. DOI: http://dx.doi.org/10.3329/jbsa.v23i2.18174 Journal of BSA, 2009; 23(2): 51-55

Are there predictive tests that determine the difficulty in LMA insertion?

2020 ◽  
pp. 1-17
Author(s):  
Gamze Kucukosman ◽  
Bengu Gulhan Ayd?n
Keyword(s):  
Laryngeal Mask Airway ◽  
Success Rate ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Laryngeal Mask Airway Insertion ◽  
Distance Ratio ◽  
Predictive Tests ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Objective: To determine the predictive tests for difficulty in laryngeal mask airway insertion, and to observe the success rate of insertion in the first attempt. Methods: The prospective, observational study was conducted at Bülent Ecevit University Hospital, Turkey, from September 2013 to 2014, and comprised patients of American Society of Anesthesiologists grade I to IV adult patients who underwent elective surgery under general anaesthesia.  The supraglottic airway device was randomly selected for each patient, and the laryngeal mask airway was used as per the decision of an anaesthesiologist who was not part of the study. Patients were divided into three groups according to laryngeal mask airway types as classic group A, i-gel group B and suprema group C. These were inserted by anaesthesia residents with the same seniority when bispectral index value reached 40-60. Data was noted and analysed using SPSS 24. Results: Of the 120 patients, 40(33.33%) were in group A, 38(31.66%) in group B, and 42(35%) in group C. There was no significant difference among the groups in terms of demographics (p>0.05). Apart from the height/thyromental distance ratio (p=0.046), no predictive test was statistically significant in identifying the difficulty in laryngeal mask airway insertion (p>0.05). There was no significant difference involving number of attempts, difficulty in insertion, and patient response (p>0.05). Placement success rate at first attempt was similar among the groups (p>0.05). Conclusion: Higher height/thyromental distance ratio values were associated with difficulty in laryngeal mask airway insertion, Continuous...  

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

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

scholarly journals A Comparative Study of Smooth Insertion of Laryngeal Mask Airway with Propofol and Thiopentone Combined with Midazolam

2018 ◽  
Vol 17 (1) ◽  
pp. 38-41
Author(s):  
Syeda Nafisa Khatoon ◽  
Md Rezaul Hoque Tipu ◽  
Sanjida Hasan ◽  
KM Baki Billah ◽  
Gulshan Ara Chowdhury ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Population Data ◽  
Laryngeal Mask ◽  
Medical College ◽  
Elective Surgical Procedures ◽  
Thiopentone Sodium ◽  
Group A ◽  
Computer Based ◽  
Group B ◽  
Insertion Condition

Background: Successful insertion of Laryngeal Mask Airway (LMA) requires sufficient depth of anesthesia and depression of airway reflexes to avoid gagging, coughing and laryngeal spasm. The LMA is popular because it is easy to insert and it provides a secure airway for the patients who breathe spontaneously. Indeed, the intravent LMA instruction manual specifically recommends propofol for induction of anesthesia during LMA insertion. As a matter of fact Propofol and LMA insertion has become synonymous. However, there are some problems related to the use of propofol, for example, relatively high cost. This observational study was conducted to compare efficacy and safety of propofol and thiopentone -midazolam in smooth insertion of LMA and the hemodynamic changes over time in both groups. Methods: The study was done in the Department of Anesthesiology, Chittagong Medical College from July, 2012 to December, 2013. All the patients scheduled for elective surgical procedures under general anesthesia fulfilling the inclusion criteria, were the study population. Data was analyzed by computer based software SPSS-21. Results: Overall LMA insertion condition was improved better by the use of midazolam with thiopentone sodium (Group B) than propofol (Group A). The drug regime used in group A (Propofol) was expensive than group B (midazolam with thiopentone sodium) with indifferent hemodynamic stability in both groups. Mean ages of patients were 32.43 years ± SD- 10.67 years in group A and 33.5 years ± SD- 10.63 years in group B. Conclusion: In the perspective of our study, for smooth insertion of LMA midazolam-thiopentone sodium regime is cheaper and can be effectively and safely used over propofol regime. Chatt Maa Shi Hosp Med Coll J; Vol.17 (1); Jan 2018; Page 38-41

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.

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.

Comparison of Frequency of Complications of i-Gel and Laryngeal Mask Airway Supreme™ in Laparoscopic Cholecystectomy

2021 ◽  
Vol 15 (12) ◽  
pp. 3180-3182
Author(s):  
Kashif Ali ◽  
Ravi Kumar ◽  
Abid Ali ◽  
Pervaiz Ali ◽  
M. Aneeque Alam ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laryngeal Mask Airway ◽  
General Anesthesia ◽  
Sore Throat ◽  
Laryngeal Mask ◽  
Medical Institute ◽  
Female Ratio ◽  
Group A ◽  
Group B ◽  
Laryngeal Mask Airway Supreme

Aim: To compare the frequency of complications of i-gel versus laryngeal mask airway supreme™ (LMA Supreme) in laparoscopic cholecystectomy. Study Design: Randomized Controlled Trial Place and Duration of Study: Department of Anesthesia, Jinnah Postgraduate Medical Institute Karachi from 16th September 2019 to 15th March 2020. Methodology: One hundred and fifty four patients having gallstones ≤5 in numbers (size <2cm) on ultrasound for >6 months requiring cholecystectomy and planned for elective list under general anesthesia of age ranges from 25-55 years of both gender were included. Patients with known or predicted difficult airway, oropharyngeal pathology, cervical spine fracture, GERD and hiatus hernia were excluded. In group A, airway was secured with i-gel while in group B, airway was secured with laryngeal mask airway supreme™. In all patients, anesthesia was given by one consultant anesthetist (at least 3 years 0f post-fellowship experience). All patients were followed by the researcher in the first 24 hours for presence or absence of dysphagia and sore throat. Results: The mean age was 34.78±6.30 years in group A and 34.38±6.37 years in group B. Majority of the patients 119 (77.27%) were between 25 to 40 years of age. There were 54 (35.06%) males and 100 (64.94%) were females with male to female ratio of ratio of 1:2.9. The complications of i-gel vs laryngeal mask airway supreme™ were found to be as follows; dysphagia on 0.0% vs 6.49% (p-value = 0.023) and sore throat in 3.90% vs 20.78% (p=0.001). Conclusion: The frequency of dysphagia and sore throat is less after i-gel use in laparoscopic cholecystectomy as compared to laryngeal mask airway supreme™. Keywords: General anesthesia, I-gel, Dysphagia

COMPARISON OF INDUCTION WITH PROPOFOLAND SEVOFLURANE FOR LARYNGEAL MASK AIRWAY INSERTION DURING ELECTIVE SURGERIES

2021 ◽  
pp. 44-46
Author(s):  
Anjani Sravanthi Kotturi ◽  
Geetha Bhavani
Keyword(s):  
Intravenous Injection ◽  
Study Groups ◽  
Laryngeal Mask ◽  
Controlled Study ◽  
Laryngeal Mask Airway Insertion ◽  
Medical Sciences ◽  
Elective Surgical Procedures ◽  
Group A ◽  
Group B

Background And Aims: Laryngeal mask airways are gaining popularity these days in airway management and can be used for various types of surgeries and also during resuscitation. The aim of the study is to compare the induction characteristics and hemodynamic changes associated with intravenous injection of Propofol or inhalational Sevourane induction for LMAinsertion during elective surgeries. Materials And Methods: It is a prospective, single blind, randomized controlled study that is conducted at Maharajah's Institute of Medical Sciences, Nellimarla,Vizianagaram from January 2019 to July 2019. The study consists of sixty patients belonging to ASA grade I & II, aged between 20-60 years of both sexes, undergoing elective surgical procedures, which were randomly divided into 2 groups of 30 each. Patients in Group-A were induced with intravenous injection of Propofol 2mg/kg and inhalation of 100% Oxygen whereas in Group-B were induced with inhalation of 8% Sevourane in 100% Oxygen. The data regarding time for induction, LMAinsertion and hemodynamic parameters were recorded and compared in both the study groups. Results: The mean time taken for induction and insertion of LMAwas less in Group A(100±13.6sec) compared to Group B(120±14.2sec) and this difference is statistically signicant. The fall in MAPand HR in group - Ais also signicant. Conclusion: The quality of anaesthesia provided by propofol is better when compared to Sevourane for LMAinsertion, even though Sevourane is associated with better haemodynamic stability.

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.

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