ABSTRACT
Background: The need of securing the airway quickly in an easier and safer way, especially in paediatric patients still remains a major concern. Newer and safer alternates to endotracheal intubations are being introduced. LMA supreme is one of such advancement in the field of paediatric anaesthesiology. Easy and quick insertion without any introducer, gastric access and high seal pressure are few advantages claimed by LMA Supreme. Apart from a few studies; the safety and efficacy of its paediatric version is yet to be established in Indian paediatric population. Thus, we have conducted an observational study for evaluation of Supreme LMA in paediatric patients. Observational clinical study. Methods: After obtaining approval from institutional ethical committee and consent from patient’s attendants, 50 patients of ASA grade I and II, weighing 10-20 kg of either sex undergoing general anaesthesia were included. After induction of anaesthesia and muscle relaxation, the LMA Supreme size 2 was inserted. Number of insertion attempts, ease of insertion, time taken for insertion, hemodynamic responses, ease of NGT insertion and incidence of airway trauma were recorded. Results: In 90% of patients, LMA Supreme was inserted in first attempt. In 94% of cases, insertion was easy. Average time required to insert LMA Supreme was 11.66 ± 0.81 seconds. There were no significant hemodynamic changes noted. In 2 % of cases, airway trauma was observed. Conclusion: LMA supreme emerged as a good alternate airway device. It is quick and easy to insert with fast learning curve with least alteration of hemodynamic status in paediatric population.
ABSTRACT
Choices of anaesthetic technique in patients with perforation peritonitis requiring emergency laparotomy vary drastically on the basis of anaesthetist preference and patient’s condition. We report a case of a geriatric male, with restricted mouth opening due to ludwig’s angina and renal derangement, posted for emergency laparotomy for gastric perforation. Thoracic epidural block was used as a sole anaesthetic technique because of above mentioned airway difficulty, instruments limitation in emergency setup and associated co- morbidity. Surgery was conducted successfully.
ABSTRACT
General anaesthesia in premature neonates is associated with various complications. Spinal anaesthesia can be better choice in premature babies in surgeries below umbilicus. Spinal anaesthesia provides all components of balance anaesthesia with minimum cardiorespiratory disturbance and post-operative nausea vomiting, early ambulation and rapid return of appetite. We report a case of one day old premature new-born who was given successful spinal anaesthesia and was operated with good outcome.