ABSTRACT
Supraglottic airway devices (SAD) are used for airway management in patients undergoing general anaesthesia, averting the need of tracheal intubation. Laryngeal mask airway is easy to insert and can be inserted by paramedics also in case of emergency. Here we primarily compared the efficacy of Baska Mask and LMA supreme in terms of ease of insertion. The secondary outcome was assessment of oropharyngeal seal pressure and post op laryngopharyngeal complications. MethodsA sample size of 30 was calculated in each group. Patients were divided into 2 groups, Group B and Group S. After giving premedication, Anaesthesia was induced with propofol 3 mg/Kg and anaesthetic depth will be deepened with 2% sevoflurane in oxygen using bag mask ventilation. An appropriately sized prior lubricated Baska mask and LMA supreme was inserted in Group B and Group S, respectively and ease of insertion was assessed. ResultsThe BM was successfully inserted in 23 patients (76.6%) in the first attempt and LMA supreme was successfully inserted in 29 patients (96.6%) in the first attempt. The difference was found to be statistically significant (P= 0.028). BM created a significantly higher oropharyngeal seal pressure than the LMA supreme group (P < 0.001). No significant difference in postoperative laryngopharyngeal complications was observed. ConclusionsFrom the present study, it is concluded that LMA supreme is easier to insert than BM. The BM creates higher oropharyngeal seal pressure and thus provides a better airway seal than the LMA supreme. The incidence of postoperative laryngopharyngeal complications is similar in both the groups.
ABSTRACT
Background: Spinal anesthesia is the preferred modality of anesthesia for lower segment cesarean section, but it is complicatedwith hypotension and bradycardia, which may be harmful to both parturient and baby. Bezold–Jarisch reflex plays an importantrole through 5HT3 receptors located in intracardiac vagal nerve endings in causing hypotension and bradycardia. In this study, weevaluated the effect of ondansetron, as a 5HT3 receptor antagonist, on the hemodynamic response following spinal anesthesiain parturients undergoing elective lower segment cesarean section.Methodology: Sixty parturients who were scheduled for lower segment elective cesarean section were randomly allocated intotwo groups. Before giving the spinal injection, Group O (n = 30) received intravenous ondansetron 4 mg and Group S (n = 30)received normal saline. Blood pressure, heart rate, and vasopressor requirements were assessed.Results: Total dose of vasopressor (mephentermine) used in Group “O” was 78 mg (mean±SD = 2.60 ± 4.36) and in Group “S,”it was 168 mg (mean ± SD = 5.6 ± 4.43 (P = 0.010). In Group O, the incidence of hypotension was 9 out of 30 patients whilein Group S, 21 out of 30 patients developed hypotension at any point of surgery (χ2=9.6 and P = 0.002).Conclusion: Ondansetron 4 mg, given intravenously 5 min before spinal anesthesia, causes reduction in hypotension andvasopressor use in parturients undergoing elective lower segment cesarean section.
ABSTRACT
Background: Baska Mask® (BM) a newer Supraglottic Airway Device (SAD) considered to cause low incidence of Postoperative Pharyngolaryngeal Complications (POPC). This study was designed to assess efficacy, safety and early and late POPC between BM and commonly use ProSeal LMA (PMLA).Methods: Patients between 18 to 60 years of age undergoing elective short gynecological procedures were randomized into two groups, to receive ventilation with either BM (group 1, n=50) or an PMLA (group 2, n=50).Results: There was no significant difference in the ease of insertion for both the devices (p<0.24). There was no significant difference in the number of attempts for both the devices (p<0.69). When compared to PLMA, the time (in seconds) required for insertion of BM was significantly less in duration (20.9 vs. 16) (p<0.0001). Between the two groups significant hemodynamic changes noticed after removal of SGA. The blood staining of device was similar in both groups. Failure to place device, postoperative complication like laryngospasm and bronchospasm did not occur in both BM and PLMA groups.Conclusions: In conclusion, findings of this study support that BM takes significantly shorter placement time and provides a better seal as compared to PLMA but without any reduction in laryngopharyngeal complications.
ABSTRACT
Introduction: Baska mask is a 3rd generation Supraglottic Airway Device (SGA). One of the major limitations of the SGA device is the risk of aspiration. Aim of the study: Evaluate the advantages of Baska mask over Proseal LMA in providing adequate laryngeal seal and ease of insertion. Materials and methods: A Randomized prospective single-blinded study. A study group of 40 female patients recruited and divided into 2 groups. Group I (BM-Baska Mask) with 20 patients and Group II (PLM- Proseal LMA) with 20 patients. All patients received general anesthesia with control ventilation. SGA device insertion was done once patients were anesthetized. Baseline intraoperative hemodynamic parameters and capnography were monitored. The ease of insertion was assessed by a number of attempts, time of insertion and any extra maneuver required. The airway pressure calculated as the plateau pressure with fresh gas flow at 6L and APL valve at 70cm H20. In Proseal LMA it was calculated using a handheld manometer. Results: The success rate of insertion was comparable in 2 groups. The mean time for insertion was 13.3 s while it was 19.7s for PLMA (Pvalue of 0`001). The mean airway sealing pressure was significantly higher in the BM group (p= 0.000). The seal pressure ranged from 20 -29 and 24 -37 in group I and II respectively with P value of 0.001 which makes it significant. There was no significant post-operative laryngopharyngeal morbidity in both groups. Conclusion: Baska mask provides an adequate seal with better ease of insertion when compared to Proseal LMA.
ABSTRACT
Background and Aims: Baska mask is a newly introduced membranous cuffed supraglottic device whereas I-gel is made up of thermoplastic elastomer, both suitably designed from the anatomical perspective of the airway. Settings and Design: We conducted randomized controlled comparative trial of the Baska mask versus I-gel in a patient undergoing laparoscopic cholecystectomy. Subjects and Methods: A total of 100 adult patients in the age group of 20–70 years undergoing elective laparoscopic cholecystectomy were randomly divided into two groups as follows: (1) Baska mask group and (2) I-gel group. The primary outcome was to compare oropharyngeal leak pressure (OLP) of Baska mask and I-gel groups. The secondary outcome was the ease of insertion and removal, number of attempts, insertion time, leak fraction, and laryngopharyngeal morbidity. Statistical Analysis Used: Demographic details were compared using the Chi-square and t-tests. Student's t-test for independent variables was used to compare means of data obtained. Results: Mean OLP was significantly higher in Baska mask group than I-gel group at insertion (29.54 ± 1.41 cm H2O vs. 23.16 ± 3.07 cm H2O, P = 0.02) and 30 min after insertion (33.54 ± 1.16 cm H2O vs. 25.97 ± 2.25 cm H2O, P = 0.001). Insertion time was 12.33 ± 2.61 s with Baska mask and 11.31 ± 1.84 s with I-gel (P = 0.02). Insertion was very easy in 58% of patients in Baska mask and 76% of patients in I-gel (P = 0.03). The leak fraction of Baska mask was significantly less than I-gel (3.56 ± 3.6 vs. 7.16 ± 2.45, P = 0.01). Laryngopharyngeal morbidity was comparable in the two groups. Conclusion: Baska mask is more effective in providing greater OLP compared to I-gel without any increase in laryngopharyngeal morbidity.