Comparative evaluation between sevoflurane and propofol for endotracheal intubation without muscle relaxants in pediatric cleft surgeries

ABSTRACT Introduction This prospective randomized study aimed to compare the effectiveness of the intubating laryngeal mask airway (ILMA) with the King Vision Video laryngoscope in aiding endotracheal intubation in Asian patients with normal airway. King Vision Video laryngoscope is a two-piece design. It has a reusable monitor that attaches to disposable blades. The ILMA is a device specifically designed to be an effective ventilatory device and blind intubating guide in patients with normal and abnormal airways. Materials and methods After ethics committee approval and obtaining patient's written informed consent, 60 American Society of Anesthesiologists grade I and II adult patients undergoing elective surgery requiring intubation were randomly allocated into either the ILMA group (Group L) or the King Vision Video laryngoscope group (Group V). • Thorough preanesthetic checkup was done. Patient was premedicated. Induction was done with propofol 2.5 mg/kg and succinylcholine 1.5 mg/kg. In Group L, ILMA was inserted using a single-handed rotational technique. In the King Vision Video laryngoscope group, intubation was done with videolaryngoscope. Placement was confirmed with auscultation and capnography. • An independent observer recorded the following: – Time taken for successful intubation – Success or failure of the tracheal intubation – Number of attempts needed for successful tracheal intubation – Complication associated with tracheal intubation: bleeding or postoperative sore throat – Hemodynamic response to intubation Results and conclusion King Vision Video laryngoscope is the more effective technique in aiding endotracheal intubation in patients with normal airways. How to cite this article Hanjura S, Agrawal AP, Agrawal M, Singh V, Vinay V, Ahmed R. Comparative Evaluation of Performance of Videolaryngoscope vs Fastrach Intubating Laryngeal Mask Airway. Int J Adv Integ Med Sci 2017;2(1):1-7.

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Endotracheal intubation without the use of muscle relaxants in patients with myasthenia gravis

Medicinski pregled ◽

10.2298/mpns0910412v ◽

2009 ◽

Vol 62 (9-10) ◽

pp. 412-416 ◽

Cited By ~ 1

Author(s):

Gordana Vlajkovic ◽

Radomir Sindjelic ◽

Dejan Markovic ◽

Milica Terzic ◽

Vesna Bumbasirevic

Keyword(s):

Myasthenia Gravis ◽

Endotracheal Intubation ◽

Muscle Relaxants ◽

Double Blind ◽

Intubating Conditions ◽

Patient Consent ◽

The Mean ◽

Student’S T ◽

Oxide Group ◽

Student’S T Test

Introduction. Although muscle relaxants have been widely used to facilitate endotracheal intubation, the administration of these drugs in myasthenic patients may be associated with adverse events. Material and methods. After obtaining Institutional Reviewing Board approval and informed, patient consent, 30 patients with myasthenia gravis were enrolled in a prospective, double-blind, randomized clinical trial. We compared intubating conditions (ease of laryngoscopy, vocal cords, cough, jaw relaxation, limb movement) following fentanyl 2 mg/kg and propofol 2 mg/kg (group PRO, n = 15) vs fentanyl 2 mg/kg and sevoflurane 5% in a 1:2 mixture of oxygen and nitrous oxide (group SEVO, n = 15). The statistical analysis was performed using Student's t test and Chi-quadrate test, p<0.05 being regarded as significant. Results. The overall intubating conditions were excellent in 67% of patients in the group PRO vs 80% of patients in the group SEVO (p>0.05). One patient in each group had clinically unacceptable conditions for intubation. The mean intubation score was 5.7?1.0 in the group PRO vs 5.9?0.9 in the group SEVO (p>0.05). Three patients receiving propofol and one patient receiving sevoflurane had mild hoarseness after the surgery (p>0.05). Conclusion. Both propofol and sevoflurane, supplemented with fentanyl, provide good intubating conditions without the use of muscle relaxants in patients with myasthenia gravis.

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The Effects of 10% Lidocaine Spray on the Pharyngolarynx during the Endotracheal Intubation without Muscle Relaxants?

Korean Journal of Anesthesiology ◽

10.4097/kjae.2001.40.2.169 ◽

2001 ◽

Vol 40 (2) ◽

pp. 169

Author(s):

Dae Hyun Jo ◽

Myoung Hee Kim ◽

Doo Cheon Cha

Keyword(s):

Endotracheal Intubation ◽

Muscle Relaxants ◽

Lidocaine Spray

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To study the adequacy of surgical muscle relaxation in paediatric patients scheduled for elective groin surgeries under general anesthesia using sevoflurane without using neuromuscular blocking agents

Annals of King Edward Medical University ◽

10.21649/akemu.v22i1.797 ◽

2016 ◽

Vol 22 (1) ◽

pp. 42

Author(s):

Muhammad Ahmad Khan ◽

Motsim Sheraz ◽

Sayed Sajjad Raza Kazmi

Keyword(s):

Endotracheal Intubation ◽

Surgical Procedures ◽

Muscle Relaxation ◽

Paediatric Population ◽

Neuromuscular Blocking ◽

Muscle Relaxants ◽

Neuromuscular Blocking Agents ◽

Blocking Agents ◽

Elective Surgical Procedures ◽

Paediatric Patients

AbstractIntroduction:In Anesthesia practice neuromuscular blocking agents (muscle relaxants) are used for intubation and surgical muscle relaxation. The use of modern inhalational anesthetics like sevoflurane is commonly practiced in paediatric anesthesia for induction and endotracheal intubation. LMA is alternative to endotracheal intubation. It is commonly used supraglotic device for the elective surgical procedures in adults and paediatric population. We conducted this study to see whether sevoflurane produces enough surgical muscle relaxation so that the use of neuromuscular blocking agents can be avoided.Patients and Methods:84 paediatric patients of King Khalid Hospital (KSA) from April 2013 to February 2014 posted for elective surgical procedure were included in this observational study regarding the adequacy of surgical muscle relaxation. Induction of anesthesia was done with propofol 2mg/kg and Fentanyl 2 mcg/ kg. Airway was maintained with LMA. Anesthesia was maintained by sevoflurane in oxygen and air. Blood pressure and Heart rate was kept with 20% of baseline reading. Adequacy of surgical muscle relaxation was asked by the surgeon during surgery and was graded as good, fair or poor.Results:Mean age of the patients was 2.4 year. There were 76 male and 8 female patients. 47 patients were operated for inguinal herniotomy, 32 for orchedopexy and 5 for umbilical herniotomy. Surgical muscle relax-ation was good in all of the patients and none of them required use of muscle relaxants. Recovery of all patients was smooth.Discussion:Adequate surgical muscle relaxation is important to facilitate surgery. In paediatric population sevoflurane produces enough muscle relaxation for intubation and surgical muscle relaxation. Monitoring of muscle relaxation can be clinical as well as through muscle twitches.Conclusion:Our study showed that in paediatric population the elective surgical procedures of groin region can be done without using muscle relaxants.Keywords:Paediatric anesthesia, LMA, neuromuscular blocking agents, surgical muscle relaxation.

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