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 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

scholarly journals Comparison of Efficacy of Laryngeal Mask Airway and Intersurgical-Gel Supraglottic Airway Device During General Anesthesia in a Tertiary Care Hospital

2019 ◽  
Vol 8 (3) ◽  
pp. 151-155
Author(s):  
Muhammad Saqib Butt ◽  
Noor Un Nisa ◽  
Ghulam Mustafa ◽  
Hasham Khan
Keyword(s):  
Laryngeal Mask Airway ◽  
General Anesthesia ◽  
Hemodynamic Response ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Care Hospital ◽  
Upper Airways ◽  
Group A ◽  
Group B

Background: Upper airways collapse during anesthesia is a common issue faced by anesthetists. Air way maintenance is an essential component of general anesthesia. Laryngeal mask airway and Intersurgical-gel (i-gel) air way devices are new advances in general anesthesia. Present study aims to compare the ease of insertion and hemodynamic response of i-gel supraglottic and laryngeal mask airway (LMA). Material and Methods: A Randomized Clinical trial was conducted at the Department of Anesthesia, Shaikh Zayed Hospital, Lahore. Study duration was 6 months (June 2014- December 2014). A total of 60 patients were selected through non-probability consecutive sampling. Ethical approval was taken from ethical review board of Sheikh Zayed Hospital and informed written consents were taken from all the participants. Patients were randomly divided into two groups using lottery method. Group A was given laryngeal mask airway device while group B patients were provided with i-gel supraglottic device during anesthesia. Patients were compared for ease of insertion and hemodynamic parameters. Data was analyzed using SPSS version 24. Chi-square and t-test were applied and p-value ≤0.05 was considered statistically significant. Results: A total of 60 patients were included in study. Mean age of patients was 35.2±11.7 years in LMA group and 36.7±13 years in i-gel group. Group B had lower number of insertion attempts (p=0.01) and high insertion satisfaction (p=0.4) as compared to group A. However, process failure and bleeding rate was found to be slightly higher in group B (16% and 13% respectively) as compared to group A (p>0.05). Conclusion: i-gel supraglottic device is a successful alternative option in terms of ease of insertion and less hemodynamic response as compared to laryngeal mask airway during general anesthesia. Key words: , , 

scholarly journals Comparison of early versus standard timing for silicone stent removal following External Dacrocystorhinostomy under local anaesthesia

2019 ◽  
Vol 11 (1) ◽  
pp. 24-28
Author(s):  
Ben Limbu ◽  
Hannah S Lyons ◽  
Mohan Krishna Shrestha ◽  
Geoffrey C Tabin ◽  
Rohit Saiju
Keyword(s):  
Success Rate ◽  
Financial Burden ◽  
Controlled Trial ◽  
Nasolacrimal Duct ◽  
Complication Rates ◽  
Tube Removal ◽  
Significant Difference ◽  
Silicone Stent ◽  
Group A ◽  
Group B

Introduction: The first line treatment for nasolacrimal duct obstruction (NLDO) is external dacrocystorhinostomy (DCR). Following DCR, patients are required to return to Tilganga Institute of Ophthalmology (TIO) six weeks postoperatively for the removal of a silicone stent. As the majority of patients travel large distances at significant cost to reach TIO, most often patients remain within Kathmandu during this six weeks interval. This places a large financial burden on patients. Methods: A randomized controlled trial was designed to compare patient outcomes after early (two weeks postoperatively) versus standard (six weeks postoperatively) removal of silicone stents. 50 selected patients were randomized into two equal groups. Results: At the time of publication, 31 patients (14 in group A and 17 in group B) had completed three months follow up. A success rate of 92.9% was noted in Group A and a success rate of 94.1% observed in group B. No significant difference was found between the two groups for success rate and rate of complications. Conclusion: Early tube removal post DCR appears to cause no significant difference in outcome or complication rates compared to standard tube removal.

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

Airway Management with the Laryngeal Mask Airway (LMA) in Emergency Medical Services

2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S8-S11
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Oxygen Saturation ◽  
Emergency Medical Services ◽  
Success Rate ◽  
Laryngeal Mask ◽  
High Success Rate ◽  
Medical Services ◽  
Supraglottic Airway ◽  
Emergency Medical

Background: Airway management is an important aspect of care in emergency medical services (EMS) used to prevent obstruction of the respiratory track and inadequate oxygenation. The laryngeal mask airway (LMA) is an easy-to-use supraglottic airway device developed in 1988 that has a high success rate in both adults and children. However, there have yet been no studies regarding LMA use in EMS in Thailand. Objective: To determine the success rate of LMA in EMS and factors associated with successful LMA insertion. Materials and Methods: This was a cross-sectional study consisting of Srinagarind Hospital EMS patients over 18 years of age who underwent LMA airway management between March 2016 and March 2020. Data were collected from the Srinagarind Hospital EMS operation database and hospital information database system. Results: A total of 154 patients were enrolled with a mean age of 43.1+8.5 years, 89 (57.8%) of whom were male. Non trauma patients accounted for 72.7% of all cases. The average oxygen saturation before and after LMA use were 71.4+12.3% and 94.4+3.2%, respectively (p = 0.022). Students in their first and third year of residency training were able to successfully perform LMA airway management on the first attempt in 83.3% and 98.4% of cases, respectively (p = 0.025). Conclusion: Airway management using the LMA had a high success rate on the first attempt, required less time for insertion than other comparable devices, and resulted in a high level of oxygen saturation. Keywords: Laryngeal mask airway, Emergency medical services, Airway management, Internship and residency

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

scholarly journals Comparison of marsupialization under nasal endoscopy versus lacrimal probing for treatment of congenital dacryocystoceles: a report of 40 cases

2020 ◽  
Author(s):  
Yan-Hui Cui ◽  
Peng Sun ◽  
Li-Xing Tang ◽  
Cheng-Yue Zhang ◽  
Qian Wu ◽  
...  
Keyword(s):  
Success Rate ◽  
Reoperation Rate ◽  
Nasal Endoscopy ◽  
Controlled Study ◽  
Lacrimal Duct ◽  
Nasal Endoscope ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background: This study was performed to compare the efficacy of marsupialization under nasal endoscopy versus lacrimal probing for the treatment of congenital dacryocystocele. Methods: A prospective randomized controlled study. Forty neonates (43 eyes) diagnosed with congenital dacryocystoceles were divided into Group A (nasal endoscopic marsupialization) and Group B (lacrimal probing). The patients were followed up for 1 year after surgery. The efficacy, incidence of complications, and reoperation rate were compared between the two groups. Results: The male:female ratio was 25:15 patients (27:16 eyes). In Group A, the success rate was 100%, the incidence of complications was 5%, and the reoperation rate was 0%. In Group B, the success rate was 90%, the incidence of complications was 20%, and the reoperation rate was 30%. There was no significant difference in the success rate between the two groups, but the incidence of complications and the reoperation rate in the lacrimal probing group(Group B) were significantly higher than those in the nasal endoscopic marsupialization group(Group A). Conclusion: In the treatment of congenital dacryocystoceles, nasal endoscope marsupialization has the same success rate as lacrimal duct probing, but the former is more effective and safer in clinical practice.

Sign in / Sign up

Export Citation Format

Share Document