Volume : 7, Issue : 2, February - 2018
RANDOMIZED DOUBLE BLIND COMPARISON OF KETAMINE - PROPOFOL AND FENTANYL - PROPOFOL FOR THE INSERTION OF LARYNGEAL MASK AIRWAY IN CHILDREN
Dr Akila Kaliannan, Dr Bhaskar Manohar
Abstract :
<p> </p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal">Background</b>: <span style="font-family:"Times New Roman","serif"">Laryngeal Mask Airway started gaining popularity as an alternative to endotracheal intubation as well as facemask because it causes less hemodynamic changes, associated with negligible raise in intraocular pressure after inserting LMA, causes decreased incidence of sore throat and also frees the hands of the anaesthesiologist to perform other important tasks during the surgical procedures </span><o:p></o:p></p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal">Methods</b>: Study design: <span style="font-family:"Times New Roman","serif"">Prospective, randomized, double blinded, comparative study</span><o:p></o:p></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal">Setting</b>: <span style="font-family:"Times New Roman","serif"">This study was conducted in the day care surgery theatre, Institute of<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">Child Health and Hospital for Children, an attached institution of Madras<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">Medical College over a period of three months.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><o:p> </o:p></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><b style="mso-bidi-font-weight: normal">Results</b>:<span style="font-family:"Times New Roman","serif""> 1. The incidence of head and limb movements was less in Group Propofol +<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">Fentanyl compared to Group Propofol+ Ketamine with p value of 0.0148<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">2. Coughing or gagging was seen in 2.86% of both the groups.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">3. Resistance to insertion was statistically significant with p value of 0.0268<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">showing more in Propofol + Ketamine group.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">4. There was no statistical significance in the occurrence of restricted mouth<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">opening, restriction to LMA insertion and occurrence of swallowing<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">between the two groups.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">5. Laryngospasm was absent in either groups.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">6. Fentanyl group showed the incidence of more apnoea compared to<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">Ketamine group.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">7. The heart rate (HR0, systolic blood pressure(SBP), diastolic blood<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">pressure(DBP) and mean arterial pressure(MAP) were statistically more<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height: normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-family: "Times New Roman","serif"">with Ketamine group than Fentanyl group.<o:p></o:p></span></p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><o:p> </o:p></b></p> <p class="MsoNormal"><b style="mso-bidi-font-weight:normal">Conclusions</b>:<span style="font-family:"Times New Roman","serif""><span style="mso-spacerun:yes"> </span>co-induction with Fentanyl (2μg/kg) prior to Propofol (2.5 mg/kg) for insertion of Laryngeal Mask Airway in children provided better insertion conditions and minimal alteration in haemodynamic parameters than co-induction with Ketamine (0.5 mg/kg) and Propofol<span style="mso-spacerun:yes"> </span>(2.5 mg/kg).</span>.<o:p></o:p></p>
Keywords :
Cite This Article:
DR AKILA KALIANNAN, DR BHASKAR MANOHAR, RANDOMIZED DOUBLE BLIND COMPARISON OF KETAMINE‾PROPOFOL AND FENTANYL‾PROPOFOL FOR THE INSERTION OF LARYNGEAL MASK AIRWAY IN CHILDREN, GLOBAL JOURNAL FOR RESEARCH ANALYSIS : VOLUME-7, ISSUE-2, FEBRUARY-2018


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