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

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.

2018 ◽  
Vol 17 (1) ◽  
pp. 38-41
Author(s):  
Syeda Nafisa Khatoon ◽  
Md Rezaul Hoque Tipu ◽  
Sanjida Hasan ◽  
KM Baki Billah ◽  
Gulshan Ara Chowdhury ◽  
...  

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


2021 ◽  
Vol 15 (12) ◽  
pp. 3232-3235
Author(s):  
M. J. Ahmed Kamal ◽  
Baber Zaheer ◽  
Naveed Ahmed Durrani ◽  
Khaleel Ahmad ◽  
Sumara Tabassam ◽  
...  

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


2015 ◽  
Vol 5 (1) ◽  
pp. 23-27
Author(s):  
H R Rehman ◽  
I Hassan ◽  
T Hussain ◽  
A A Mir ◽  
M Zahid

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


2019 ◽  
Vol 26 (03) ◽  
Author(s):  
Marium Shoukat ◽  
Hijab Batool ◽  
Faiza Javaid

Objectives: Role of niacin in decreasing cardiovascular accidents by lowering the levels of Apo-B in hyperlipidemic patients. Background: In hyperlipidemia, there are high levels of atherogenic lipoproteins leading to higher risk of atherosclerotic cardiovascular events. Patients with dyslipidemia use statins as a mainstay of therapy over last many decades. Recent studies show that apolipoproteins play a major role in formation of atheromatous plaque, thus there is an urgent need to study the effects of lipid lowering medication on apolipoprotiens levels. Study Design: Cross sectional analytical study. Setting: Sheikh Zayed Hospital Lahore (Department of Biochemistry and Chemical Pathology). Period: 12 weeks from July to Sep 2014. Materials and Methods: Recently diagnosed hyperlipidemic patients (n=44) were selected for the study purpose and divided into two equal groups; A and B. Each group was given different medication. Group A took only statin while group B took a combination of statin and niacin. Blood samples were taken at the start of medication and then after completion of 12 week time period. Results: At the start of the treatment there was no significant difference in the Apo B cholesterol level between the two groups (p value 0.972). However, after the end of 12 week duration, there was a significant reduction in the Apo level of group B taking statin and niacin as compared to group A taking statin alone (p value 0.003). Conclusions: Niacin has cardio-protective role when used in combination with niacin.


2014 ◽  
Vol 23 (2) ◽  
pp. 51-55
Author(s):  
Azizul Gafur ◽  
Mustafa Kamal ◽  
Ashia Alia ◽  
Idris Ali ◽  
Amirul Islam ◽  
...  

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


2015 ◽  
Vol 22 (11) ◽  
pp. 1550-1524
Author(s):  
Khawar Saeed Jamali ◽  
Naveed Ali Khan ◽  
Muhammad Jawed ◽  
Ubedullah Shaikh

Objectives: The objective of this study was to compare the outcome of diathermyincisions v/s surgical scalpel incisions in general surgery. Study Design: Cross sectional study.Place and Duration of Study: This study was conducted at surgical unit 7, Sindh Govt. LyariGeneral Hospital and Dow University of Health Sciences between January to December 2009.Methodology: 100 consecutive patients for elective general surgery were randomly assignedto either group A incision with cutting diathermy (n=50) or group B cold steel scalpel (n=50).Data including demographic details, hospital stay, infection rate and non-infective complicationslike swelling, bleeding, dehiscence and seroma formation were recorded in both groups tocompare the final surgical outcome compared. Results: A total of 80 patients were included inthe study, placed alternatively into two groups of 40 patients each with majority being male (n =61, 76.3%). The mean age was 22.46 years. The positive predictive value for patients of Group Awas 92.5% while for Group B was 77.5%. When diagnostic accuracy was compared on the basisof Gender for the two groups, the positive predictive value for male patients of Group A and Bwas 90.09% and 89.28% respectively, but for females the positive predictive value of Group Aand B was 100% and 50% respectively. In Diathermy (Group A) total 20% patients developedcomplications and these were seroma formation (n=4, 8%), wound dehiscence (n=3, 6%) andwound infection (n=3, 6%). In Scalpel (Group B) total 26% patients developed complications(P-value=0.370) in which seromas was noted (n=5, 10%) then wound infection (n=4, 8%), thenwound bleeding (n=3, 6%) and lastly seroma formation (n=1, 2%). Hospital stays were alsoalmost similar with mean value 8.24 days in diathermy group and 10.54 days in scalpel group.No remarkable difference in demographics, characteristics and in other variables of patientswas noted. Conclusion: We conclude that no significant difference in surgical outcome ofboth groups (cutting diathermy Vs. steel scalpel). Therefore, use of either technique to createsurgical wound merely depends upon preference of surgeon.


2020 ◽  
Vol 27 (03) ◽  
pp. 607-612
Author(s):  
Humaira Ahmad ◽  
Amna Tariq ◽  
Asif Sagheer ◽  
Aisha Ahmad ◽  
Samina Aslam

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.


2021 ◽  
Vol 71 (5) ◽  
pp. 1582-84
Author(s):  
Hassam Anjum Mir ◽  
Mubashir Sharif ◽  
Ali Asif ◽  
Maleeha Shamim ◽  
Maaz Qureshi ◽  
...  

Objective: To determine if the traditional chewing stick Miswak was as effective in cleaning teeth as Toothbrush. Study Design: Cross sectional study. Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi, from Aug 2020 to Jan 2021. Methodology: A total of 300 subjects were included which were divided in two groups on the basis of whether they used miswak or toothbrush as a cleaning aid. Group A was toothbrush users and group B was Miswak user. Plaque Index was used to determine the cleanliness of teeth. The scores were recorded and data analyzed using SPSS-23. Results: The means and standard deviations of Plaque Index score for group A and B were 0.96 ± 0.58 and 0.98 ± 0.56 respectively. The comparison of Plaque Index score for both groups was insignificant with the p-value of 0.083. Conclusion: Within the limitations of this study, it is concluded that, no significant difference was found in the effectiveness of traditional miswak and tooth brush. It is recommended that if the technique of teeth cleaning is good then any of the abovementioned means of teeth cleaning can be used.


2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Muhammad Ali Haider ◽  
Uzma Sattar ◽  
Muhammad Amjad

Purpose:  To compare the Central subfoveal choroidal thickness (CCT) in diabetic patients with and without diabetic retinopathy. Study Design:  Cross sectional observational study. Place and Duration of Study:  Al-Ehsan Welfare Eye Hospital, Lahore, from June 2019 to May 2020. Methods:  One hundred and twenty patients with type II diabetes were included with a mean age of57±0.9. Patients were divided into two groups (60 in each group) based on presence or absence of diabetic retinopathy after ophthalmic examination. Group A comprised of patients showing signs of retinopathy and group B with no signs of diabetic retinopathy. After detailed ophthalmic examination, spectral–domain OCT was performed for the measurement of central subfoveal choroidal thickness. The differences in measurements were analyzed and measured by using SPSS version 22. Results:  Out of 120 patients, 69 (57.5%) were males and 51 were females (42.5%).  Mean age of patients was 58.8 ± 10 years with minimum 28 years and maximum 94 years. Central choroidal thickness in group A showed a mean value of 239 ± 41 µm with standard error of mean 3.76. While diabetic patients having no signs of diabetic retinopathy (Group B) showed mean subfoveal choroidal thickness of 240 ± 42 µm with standard error of mean 3.89. The difference in central subfoveal choroidal thickness in both groups was 1.337 which is statistically insignificant with p value of 0.250. Conclusion:  Central choroidal thickness amongst diabetic patients with and without signs of retinopathy does not have any significant changes. Key Words:  Choroid, Diabetic retinopathy, Optical Coherence Tomography.


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