comparative study evaluating the efficacy of cuffed oropharyngeal airway and the laryngeal mask airway in spontaneously breathing anesthetized patients

The cuffed oro-pharyngeal airway [COPA], a modified Guedel airway, was compared with laryngeal mask airway [LMA] during spontaneous breathing anesthesia. Parameters of comparison were ease of use, physiological tolerance, hemodynamics and the frequency of clinical problems. We studied 50 adult patients, ASA grade I and II undergoing short surgical procedures. The patients were randomly allocated into two groups of 25 each, group I [COPA] and group II [LMA] were pre-medicated with intravenous glycopyrrolate, intravenous midazolam and pentazocine for sedation. Intravenous propofol was the inducing agent, and the patients was maintained using oxygen, nitrous oxide and sevoflurane. The insertion time, number of attempts, ease of insertion, airway manipulations, hands free anesthesia, hemodynamic parameters, complications and overall efficacy with the use of either device were compared. In group I, in 92% of cases insertion was easy and successful in the first attempt, in group II, it was 80%. Less time required in group I versus group II but more airway manipulations were needed in group I in order to achieve unobstructed airway, hence not very good for hand free anesthesia. Hemodynamic parameters were comparable in the two groups Complication rate was less and the overall assessment for COPA was graded as good. Thus, the cuffed oropharyngeal airway is comparable to laryngeal mask airway but it is not better as far as hand free anesthesia is concerned

Comparative evaluation of intra-articular administration of morphine, bupivacaine and morphine with bupivcaine for post operative analgesia following video knee arthroscopy

Post arthroscopy analgesia has been provided with intra-articular bupivacaine, but the duration of analgesia was short. In contrast intra-articular morphine has been shown to produce significant but delayed post-operative analgesia. So, the combination of intra-articular morphine and bupivacaine may be the ideal analgesic after knee arthroscopoy. Our work was done to clarify this suggestion, seventy five patients ASA grade I and II, aged 20-60 years, undergoing elective knee arthroscopy under general anesthesia, were randomized into three groups: group I received morphine 2 mg in 20cc saline, group II received 20cc of 0.25% of bupivacaine, group III received morphine 2 mg in 20cc of 0.25% of bupivacaine intra-articularly. The visual analogue score [VAS] were performed at 1, 3, 6, 12, and 24 hours post operatively. Group III had significantly lower VAS compared to the other groups at the end of the study, so morphine and bupivacaine provides superior post operative analgesia for up to 24 hours versus bupivacaine or morphine individually