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Fatima, Nida
- Second Generation Extraglottic Airway Devices (AMBU, Air-Q & I-LMA): a Comparative Study to Assess the Relative Success Rate in First Attempt and Safety for Blind Tracheal Intubation
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PDF Views:78
Authors
Affiliations
1 Shri Mahant Inderesh Hospital, Dehradun, Uttrakhand, IN
2 Department of Anaesthesiology, J. N. Medical College, A.M.U., Aligarh 202002, U.P., IN
3 Integral Institute of Medical Sciences & Research, Lucknow, IN
1 Shri Mahant Inderesh Hospital, Dehradun, Uttrakhand, IN
2 Department of Anaesthesiology, J. N. Medical College, A.M.U., Aligarh 202002, U.P., IN
3 Integral Institute of Medical Sciences & Research, Lucknow, IN
Source
Central Journal of ISA, Vol 1, No 2 (2017), Pagination: 49-56Abstract
Background and Aims: Since introduction of classic LMA by Archie Brain, the newer second generation extraglottic airway devices are easily available in the market; the current study was designed to assess and compare the relative success rate of blind endotracheal intubation in first attempt through LMA-Fastrach, Air-Q ILA, and Ambu Aura-i as a primary endpoint. Methods: One hundred and fifty patients aged between 18 and 60 years with ASA physical status I-II, MP Grade 1-II, undergoing elective surgery under general anaesthesia, were enrolled into this prospective, randomised, case-control study to compare the relative success rate of tracheal intubation through LMA- FastrachTM(Group F=50 patients) Air-QTM ILA (Group Q = 50 patients) and AMBU-Aura i (Group A=50 patients) in first attempt via standard PVC tube. Results: First attempt successful intubation through SAD was 92% in group F, 88% in group Q and 84% in Ambu aura i group but no significant difference was seen among the groups. However, tracheal intubation was performed successfully in shorter time with Air Q-ILA (34.91±11.61 sec) as compared to AMBU-Aura and ILMA (36.59±13.92 and 37.66±12.66 sec) which was statistically insignificant (p= 0.599). Conclusion: All the three second generation extraglottic airway devices are reliable and effective can be used as conduit for tracheal intubation safely without any major complication with high success rate.Keywords
Ambu® Aura-iTM, Blind Endotracheal Intubation, Extraglottic Airway Devices, First Attempt Success Rate, LMA- FastrachTM Air-qTM ILA.Full Text
References
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- Ferson DZ, Rosenblatt WH, Johansen MJ, Osborn I, Ovassapian A, David Z, et al. Use of the intubating LMA-FastrachTM. in 254 patients with difficult-to-manage airways. Anesthesiology. 2001; 95(5):1175.81. https://doi.org/10.1097/00000542-200111000-00022 PMid:11684987.
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- The Effect of Clonidine on Peri-Operative Neuromuscular Blockade and Functional Recovery: A Randomized Placebo-Controlled Trial
Abstract Views :453 |
PDF Views:106
Authors
Affiliations
1 Department of Anaesthesiology, Integral Institute of Medical Sciences and Research, Lucknow, Uttar Pradesh, IN
2 King George's Medical University (KGMU), Lucknow, Uttar Pradesh, IN
3 Department of Anaesthesiology and Critical Care, J.N. Medical College, AMU, Aligarh, Uttar Pradesh, IN
1 Department of Anaesthesiology, Integral Institute of Medical Sciences and Research, Lucknow, Uttar Pradesh, IN
2 King George's Medical University (KGMU), Lucknow, Uttar Pradesh, IN
3 Department of Anaesthesiology and Critical Care, J.N. Medical College, AMU, Aligarh, Uttar Pradesh, IN
Source
Central Journal of ISA, Vol 2, No 2 (2018), Pagination: 44-51Abstract
Background: Alpha-2-agonists are as used adjunct for anaesthesia. We conducted this study with the aim to determine whether the addition of clonidine, an α-2-agonist, decreases the time to recovery from neuromuscular blockade caused by non-depolarising muscle relaxant. Secondary objectives were to know whether clonidine as an adjuvant improves hemodynamic stability, decreases stress hyperglycaemia, pain and time to discharge from Post-Anaesthesia Care Unit (PACU).
Methods: This placebo-controlled clinical trial, enrolled 64 patients into clonidine (n = 32) or placebo (saline) group (n = 32). Study drug was given 1.5 mcg/kg IV bolus at the time of induction followed by infusion (1.5 mcg/kg/hour) intra-operatively. Extubation was started when train-of-four (TOF) count was ≥ 2. Primary outcome measure was time to achieve TOF ratio of ≥ 70% and ≥ 90%, assessed at 5, 15, 30- and 60-min intervals following extubation.
Results: 2 patients in each group were excluded due to intra-operative requirement of additional supportive medications, hence in each group 30 were analysed. Significant difference was observed between clonidine and placebo groups in terms of time to achieve TOF ratio ≥ 70% and ≥ 90%, stress hyperglycemia, hemodynamic and pain profile, no statistical difference in the Ramsey sedation score and modified Aldrete score between groups. Patients given clonidine required repeat doses of non-depolarising muscle relaxant at longer intervals, with decrease in total amount administered. Clonidine group had a median time to achieve TOF ratio ≥ 70% at 15 min compared to 60 min in placebo group.
Conclusion: Clonidine hastens the recovery from neuromuscular block with reduced stress hyperglycaemia and post-operative pain, along with unaffected Ramsey sedation score and modified Aldrete score.
Keywords
Clonidine and Neuromuscular Recovery, Clonidine and Functional Recovery.Full Text
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