Volume : 7, Issue : 11, November - 2018
LARYNGEAL MASK AIRWAY PLACEMENT IN CHILDREN: COMPARISION BETWEEN DIFFERENT TECHNIQUES.
Dr Krunal Patel, Dr Kinjal Vaghela
Abstract :
<p> </p> <p class="MsoNormal" style="text-align:justify"><b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;mso-bidi-font-family:Calii; mso-bidi-theme-font:minor-latin">Introduction</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;mso-bidi-font-family:Calii; mso-bidi-theme-font:minor-latin">: </span><span lang="EN-IN" style="font-size: 12.0pt;line-height:115%;mso-bidi-font-family:"Times New Roman"">LMA is effective idge between facemask and endotracheal tube. It does not stimulate the infraglottic structure thus minimizing stress response and airway resistance, associated with fewer cardiovascular and respiratory changes than endotracheal intubation. Inflatable cuff of LMA provides a low pressure seal over glottis and allows positive pressure ventilation. There are 3 technique of insertion: standard (ain), lateral and rotational.<o:p></o:p></span></p> <p class="MsoNormal"><b><span lang="EN-IN" style="font-size:12.0pt;line-height: 115%;mso-bidi-font-family:"Times New Roman"">Aims and objective</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;mso-bidi-font-family:"Times New Roman"">:The aim of study was to evaluate and compare insertion of LMA in child via the standard, the rotational and the lateral approach with the following objectives.<o:p></o:p></span></p> <p class="MsoListParagraphCxSpFirst" style="margin-bottom:8.0pt;mso-add-space: auto;text-indent:-.25in;line-height:107%;mso-list:l0 level1 lfo1"><!--[if !supportLists]--><span lang="EN-IN" style="font-size:12.0pt;line-height:107%;mso-bidi-font-family:Calii; mso-bidi-theme-font:minor-latin"><span style="mso-list:Ignore">1)<span style="font:7.0pt "Times New Roman""> </span></span></span><!--[endif]--><span lang="EN-IN" style="font-size:12.0pt;line-height:107%;mso-bidi-font-family:"Times New Roman"">Success rate and ease of insertion<o:p></o:p></span></p> <p class="MsoListParagraphCxSpMiddle" style="margin-top:0in;margin-right:0in; margin-bottom:8.0pt;margin-left:1.5in;mso-add-space:auto;text-indent:-.25in; line-height:107%;mso-list:l1 level1 lfo2"><!--[if !supportLists]--><span lang="EN-IN" style="font-size:12.0pt;line-height:107%;font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman""> </span></span></span><!--[endif]--><span lang="EN-IN" style="font-size:12.0pt; line-height:107%;mso-bidi-font-family:"Times New Roman"">Number of attempts<o:p></o:p></span></p> <p class="MsoListParagraphCxSpMiddle" style="margin-top:0in;margin-right:0in; margin-bottom:8.0pt;margin-left:1.5in;mso-add-space:auto;text-indent:-.25in; line-height:107%;mso-list:l1 level1 lfo2"><!--[if !supportLists]--><span lang="EN-IN" style="font-size:12.0pt;line-height:107%;font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman""> </span></span></span><!--[endif]--><span lang="EN-IN" style="font-size:12.0pt; line-height:107%;mso-bidi-font-family:"Times New Roman"">Ease of insertion<o:p></o:p></span></p> <p class="MsoListParagraphCxSpMiddle" style="margin-top:0in;margin-right:0in; margin-bottom:8.0pt;margin-left:1.5in;mso-add-space:auto;text-indent:-.25in; line-height:107%;mso-list:l1 level1 lfo2"><!--[if !supportLists]--><span lang="EN-IN" style="font-size:12.0pt;line-height:107%;font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman""> </span></span></span><!--[endif]--><span lang="EN-IN" style="font-size:12.0pt; line-height:107%;mso-bidi-font-family:"Times New Roman"">Time taken for successful insertion<o:p></o:p></span></p> <p class="MsoListParagraphCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space: auto;text-indent:-.25in;line-height:107%;mso-list:l0 level1 lfo1"><!--[if !supportLists]--><span lang="EN-IN" style="font-size:12.0pt;line-height:107%;mso-bidi-font-family:Calii; mso-bidi-theme-font:minor-latin"><span style="mso-list:Ignore">2)<span style="font:7.0pt "Times New Roman""> </span></span></span><!--[endif]--><span lang="EN-IN" style="font-size:12.0pt;line-height:107%;mso-bidi-font-family:"Times New Roman"">Adverse events during insertion of LMA.<o:p></o:p></span></p> <p class="MsoListParagraphCxSpMiddle" style="margin-bottom:8.0pt;mso-add-space: auto;text-indent:-.25in;line-height:107%;mso-list:l0 level1 lfo1"><!--[if !supportLists]--><span lang="EN-IN" style="font-size:12.0pt;line-height:107%;mso-bidi-font-family:Calii; mso-bidi-theme-font:minor-latin"><span style="mso-list:Ignore">3)<span style="font:7.0pt "Times New Roman""> </span></span></span><!--[endif]--><span lang="EN-IN" style="font-size:12.0pt;line-height:107%;mso-bidi-font-family:"Times New Roman"">Hemodynamic changes<o:p></o:p></span></p> <p class="MsoListParagraphCxSpLast" style="margin-bottom:8.0pt;mso-add-space: auto;text-indent:-.25in;line-height:107%;mso-list:l0 level1 lfo1"><!--[if !supportLists]--><span lang="EN-IN" style="font-size:12.0pt;line-height:107%;mso-bidi-font-family:Calii; mso-bidi-theme-font:minor-latin"><span style="mso-list:Ignore">4)<span style="font:7.0pt "Times New Roman""> </span></span></span><!--[endif]--><span lang="EN-IN" style="font-size:12.0pt;line-height:107%;mso-bidi-font-family:"Times New Roman"">Intra and post-operative complication.<o:p></o:p></span></p> <p class="MsoNormal"><b><span lang="EN-IN" style="font-size:12.0pt;line-height: 115%;mso-bidi-font-family:"Times New Roman"">Material and methods</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;mso-bidi-font-family:"Times New Roman"">:<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%; mso-bidi-font-family:"Times New Roman"">After the approval of ethical committee, 105 ASA grade 1 and 2 patients of age 1-12 years undergoing surgery were included in the surgery and randomly allotted in 3 groups:<o:p></o:p></span></p> <p class="MsoNoSpacing"><span lang="EN-IN" style="font-size:12.0pt;mso-bidi-font-family: "Times New Roman"">Group S (n=35): LMA placement with standard technique<o:p></o:p></span></p> <p class="MsoNoSpacing"><span lang="EN-IN" style="font-size:12.0pt;mso-bidi-font-family: "Times New Roman"">Group R (n=35): LMA placement with rotational technique<o:p></o:p></span></p> <p class="MsoNoSpacing"><span lang="EN-IN" style="font-size:12.0pt;mso-bidi-font-family: "Times New Roman"">Group L (n=35): LMA placement with lateral technique<o:p></o:p></span></p> <p class="MsoNoSpacing"><span lang="EN-IN" style="font-size:12.0pt;mso-bidi-font-family: "Times New Roman""><o:p> </o:p></span></p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%; mso-bidi-font-family:"Times New Roman"">After achieving standard anaesthesia protocol, LMA was inserted by skilled anaesthesiologist. Time for successful insertion, ease of insertion, number of attempts, adverse events, hemodynamic changes, intra and post-operative complications were noted. <o:p></o:p></span></p> <p class="MsoNormal"><b><span lang="EN-IN" style="font-size:12.0pt;line-height: 115%;mso-bidi-font-family:"Times New Roman"">Results:<o:p></o:p></span></b></p> <p class="MsoNormal"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%; mso-bidi-font-family:"Times New Roman"">First attempt success rate is 94% and second attempt success rate is 100% in rotational technique, which is higher than standard and lateral technique. Ease of insertion and less time was taken in rotational technique. Less adverse effects and intra/post-operative complications noted in rotational technique. No statistically significant hemodynamic changes were noted intra and post-operatively.<o:p></o:p></span></p> <p class="MsoNormal"><b><span lang="EN-IN" style="font-size:12.0pt;line-height: 115%;mso-bidi-font-family:"Times New Roman"">Conclusion</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;mso-bidi-font-family:"Times New Roman"">:<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;mso-bidi-font-family:"Times New Roman"">Rotational technique is better than standard and lateral technique in terms of first attempt success rate, ease of insertion, time take for insertion and less intra and post-operative complication.<o:p></o:p></span></p>
Keywords :
Cite This Article:
LARYNGEAL MASK AIRWAY PLACEMENT IN CHILDREN: COMPARISION BETWEEN DIFFERENT TECHNIQUES. , Dr Krunal Patel, Dr Kinjal Vaghela , GLOBAL JOURNAL FOR RESEARCH ANALYSIS : Volume-7 | Issue-11 | November-2018


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