ABSTRACT
Introduction: Airway management is an essential component in the first aid of medical emergencies in the combat medical care. Though Endotracheal tube (ETT) is considered ideal for airway management, supraglottic airway devices (SGA) are gaining popularity as an alternative. We studied the use of a novel SGA device (BASKA® mask) in hospital which can be extended to the combat situation. Methods: In this randomised, clinical study, we compared two airway devices (ETT and Baska® Mask) for ventilation in patients (n=100) undergoing laparoscopic surgery. We evaluated the mean airway seal pressure, ease of insertion, time taken for insertion and the complication rates with the use of airway devices. The data were analyzed using appropriate statistical tests. Results: We found that the mean airway seal pressures were comparable with the two devices. The first–time success rate for insertion was higher with the Baska® mask than with the ETT (94% vs 70%) respectively (p < 0.001). The overall device insertion success rates were comparable between the two devices (100% vs 96% respectively, p = 0.5412). Conclusion: Baska® mask is comparable on various parameters to the ETT and is easier to insert due to its flexible head. This is relevant for airway management during combat medical support in field situations.
ABSTRACT
Background: Pulmonary hypertension (PHT), if present, can be a significant cause of increased morbidity and mortality in children undergoing surgery for congenital heart diseases (CHD). Various techniques and drugs have been used perioperatively to alleviate the effects of PHT. Intravenous (IV) sildenafil is one of them and not many studies validate its clinical use. Aims and Objectives: To compare perioperative PaO2 – FiO2 ratio peak filling rate (PFR), systolic pulmonary artery pressure (PAP) – systolic aortic pressure (AoP) ratio, extubation time, and Intensive Care Unit (ICU) stay between two groups of children when one of them is administered IV sildenafil perioperatively during surgery for CHDs. Materials and Methods: Patients with ventricular septal defects and proven PHT, <14 years of age, all American Society of Anesthesiologists physical status III, undergoing cardiac surgery, were enrolled into two groups – Group S (IV sildenafil) and Group C (control) – over a period of 14 months, starting from October 2013. Independent t‑test and Mann–Whitney U‑test were used to compare the various parameters between two groups. Results: PFR was higher throughout, perioperatively, in Group S. PAP/AoP was 0.3 and 0.4 in Group S and Group C, respectively. In Group S, mean group extubation time was 7 ± 7.34 h, whereas in Group C it was 22.1 ± 10.6. Postoperative ICU stay in Group S and Group C were 42.3 ± 8.8 h and 64.4 ± 15.9 h, respectively. Conclusion: IV sildenafil, when used perioperatively, in children with CHD having PHT undergoing corrective surgery, improves not only PaO2 – FiO2 ratio and PAP – AoP ratio but also reduces extubation time and postoperative ICU stay.