ABSTRACT
Background: Airway management is considered as an integral part of general anesthesia. Use of Baska mask, since asupraglottic airway device, could result in the low incidence of hemodynamic alterations and post-operative pharyngolaryngealcomplications. We conducted this study to compare the hemodynamic parameters, i.e., systolic blood pressure (SBP),diastolic blood pressure, mean arterial pressure (MAP), heart rate (HR), ease of insertion, time of insertion, and post-operativepharyngolaryngeal complications during Baska mask and endotracheal tube (ETT) insertion.Materials and Methods: It was a prospective randomized study which was conducted on 80 adult patients admitted for electivesurgery under general anesthesia (GA) of 60–90 min duration. A total of 80 patients were randomly allocated into two groups,i.e., Group B and Group E of 40 each. Group B patients underwent Baska mask insertion and Group E patients underwent ETTinsertion. The statistical analysis was done by Student’s t-test and Chi-square test. P < 0.05 was considered statistically significant.Results: There was a statistically significant rise in SBP, diastolic blood pressure, MAP, and HR during ETT insertion as comparedto Baska mask insertion. The mean time of insertion of Baska mask was 12.8 ± 1.36 s and of ETT was 15.93 ± 1.51 s. Insertionof Baska mask was easy in 85% whereas insertion of ETT was easy in 65%.Conclusion: Baska mask can be used as an alternative to ETT in adult patients undergoing surgeries under GA of 60–90 minduration with minimal hemodynamic alterations and post-operative pharyngolaryngeal complications.
ABSTRACT
Introduction: Laryngeal mask airway (LMA) cuff pressure has been implicated as a prime reason for post-operative sore throat.LMA cuff pressure increases when the air is used for the cuff inflation during oxygen: Nitrous oxide (O2: N2O) anesthesia, whichresults in post-operative pharyngolaryngeal adverse events. We conducted this study to compare the effect of LMA supremecuff inflation with air, air: Oxygen, and oxygen: Nitrous oxide mixture in adults.Aim: The aim of the study was to compare the changes in cuff pressure intraoperatively with different gas composition (air,air: Oxygen mixture, and oxygen: Nitrous oxide mixture) used to inflate the LMA supreme by a manometer and post-operativepharyngolaryngeal morbidity.Design: It was a potential randomized double-blind study which was conducted on 120 patients admitted for elective surgeryunder general anesthesia.Materials and Methods: A total of 120 patients were randomly allocated into three groups of 40 each according to thecomposition of gases used to inflate the supreme LMA cuff to achieve 40 cm H2O cuff pressure, air was used as cuff inflationmedium in Group A, air: Oxygen mixture in Group AO, and oxygen: Nitrous oxide mixture in Group ON.Statistical Analysis: The cuff pressure, ventilatory parameters, and post-operative pharyngolaryngeal complications werenoted. The analysis was done by Student’s t-test and Chi-square test. P < 0.05 was considered statistically significant.Results: In Group A and Group OA cuff pressure significantly increased from initial cuff pressure of 40 cm H2O until the end ofthe surgery to 74.35 ± 7.41 cm H2O and 56.35 ± 3.63 cm H2O, respectively. An initial decrease in cuff pressure was observedat 15 min to a mean of 32.85 ± 1.42 cm H2O in Group ON which again gradually increased to near initial pressures to a meanof 40.10 ± 2.31 cm H2O toward the end of surgery. Cuff volume increased in Group A and Group AO; however, it decreased inGroup ON (23.18 ± 4.45 ml, 18.73 ± 2.61 ml, and 11.50 ± 1.93 ml, respectively) from initial values. Ventilatory and hemodynamicparameters were comparable in all the three groups. A significant difference in pharyngolaryngeal morbidity was observedbetween Group A and Group ON.Conclusion: Cuff inflation with 50% O 2: N2O mixture provided more stable cuff pressure in comparison to air and O2: Air mixtureduring O2: N2O anesthesia. Ventilatory parameters and hemodynamic parameters did not change with variation in SLMA cuffpressure. Post-operative pharyngolaryngeal morbidity had a strong correlation with cuff pressure and was more in Group Aand least in Group ON.