Airway device; comparison of l-GEL supraglottic with laryngeal mask airway

Intersurgical-gel [I-gel] is a new supraglottic airway device that is widely being used to secure airway during general anaesthesia. The objective of the study is to compare the ease of insertion of Intersurgical-gel and Laryngeal mask airway [LMA]. This study was conducted in Department of anaesthesia Hameed Latif Hospital, Lahore. 100 American Society of Anesthesiologists [ASA] I-II, patients were enrolled in this study for elective surgery divided in 2 groups of 50 each. LMA and l-gel were used in groups A and B respectively for intra operative maintenance of airway. Randomization through random number table in Statistical Package for Social Sciences [SPSS] version 17 was used. There were 50 patients in both groups. There were no statistical significant difference between the patients age of two groups. There was absolutely no difference between 2 groups regarding ease of insertion because both groups had 84% easy and 16% satisfactory insertions. Insertion time of LMA and l-gel in first and second attempt were also comparable and statistically nonsignificant. Airway manipulations was required in both groups for insertion of device, in LMAgroup 30% required and 70% did not require and in i-gel group 48% required and 52% did not require. There is no statistical significant difference between both groups. Bleeding was noticed on 2% of i-gel and with LMA no bleeding occurred and 2% laryngospasm incidence noticed in both groups. we found that regarding ease of insertion there is statistically no significant difference between l-gel and LMA

Administration of local anaesthetics through epidural needle before catheter insertion does not improve the quality of anaesthesia or reduce catheter related complications

The objective of this study was to compare the effect of injecting local anaesthetics through epidural needle and catheter on quality of anaesthesia and catheter related complications. We randomized 60 patients into 2 equal groups; in the Needle Group [n=30], catheters were inserted after injection of a full dose of local anesthetic through the needle. In the Catheter Group [n=30], the catheters were inserted immediately after identification of the epidural space; local anesthetic was then injected via the catheter. The groups were compared for paresthesias, inability to advance the catheter, intravenouos or subarachnoid catheter placement; sensory and motor block were assessed 20 min after the injection of local anesthetic. Statistical analysis was performed by SPSS for Windows [version 10.0] Patient characteristics were analyzed using the t-test for independent groups. Block height, perioperative anesthesia quality and incidences of catheter related complications were analyzed using chi square test. Thoracic level sensory block and motor block was comparable in both the groups. Frequency of paresthesia during catheter placement was comparable; [23.3% versus 13.3% P=0.3]. Intra-vascular catheterization occurred in 23.3% versus 10% of patients in the catheter and needle groups, respectively [P=0.166]. Excellent surgical conditions were statistically similar in both the groups. Injecting local anaesthetic through the epidural needle before catheter placement does not reduce catheter-related complications or improve the qualityof epidural anesthesia

Comparative study of oral erythromycin-ranitidine combination and metoclopramide-ranitidine combination in reducing residual gastric fluid volume and acidity in elective surgery

Prokinetic agents and H-2 receptor antagonists are commonly used to decrease the volume and increase the pH of the gastric fluid. This study was conducted to compare the effect of oral erythromycin-ranitidine combination and metoclopramide-ranitidine combination in reducing gastric fluid volume and acidity in patients undergoing elective surgery. 80 patients were divided into two groups by convenient sampling technique after meeting inclusion criteria; Group A was given oral erythromycin 250 mg-ranitidine 150 mg while group B was given oral metoclopramide 10 mg-ranitidine 150 mg two hours before surgery. Gastric fluid was aspirated with orogastric tube after induction. Volume and pH of the gastric fluid were determined. Data analysis of our study showed statistically significant reduction in mean gastric fluid aspirate volume in group A [3.4ml+2.3 vs. 7.2m1+3.1]. [P-value = 0.001 and T-value = 6.24]. There was no statistically significant difference between the two groups as far as increase in gastric pH was concerned [6.5+1.6 vs. 6.2+1.3]. [T-value = 0.925 / Two tailed P-value = 0.36]. In both the groups' gastric pH was increased from the average normal value [0.3-2.9]. Combination of erythromycin-ranitidine is more effective than metoclopramide-ranitidine in reducing the gastric aspirate fluid volume and thus in prevention of acid aspiration syndrome