comparative analysis of the Baska Mask vs. proseal laryngeal mask for general anesthesia with IPPV

To compare the sealing pressure of the Baska Mask [BM] with Proseal laryngeal mask [PLM] in patients undergoing general anesthesia for a variety of elective non-head and neck surgical procedures.. Prospective, randomized, ethical issues committee approved interventional study. Setting: Operating rooms of Khoula Hospital, Muscat [Oman]. 52 consecutive adult patients of either sex requiring general anesthesia were included in the study. Patients with BMI >30, having known tendency to nausea/vomiting or pharyngeal pathology were excluded from the study. Following uniform induction with propofol 2-2.5 mg/kg, fentanyl 1.0-1.5 ug/kg, and relaxation with cisatracurium 0.1 mg/kg, either BM [n=30] or PLM [n= 22] was placed. Primary outcome measure was airway seal pressure while secondary outcome measures included device insertion time, number of attempts, leak fraction, duration of use, and laryngopharyngeal morbidity [sore throat, dysphagia, and dysphonia] at 1 hour and 4 hours postoperatively. Data collection was done by a staff member not involved with the study. The mean insertion time was significantly shorter in the BM group as compared to the PLM group [16.43 +/- 4.54 vs. 21.45 +/- 6.13] [P=0.001]. Mean sealing pressure was significantly higher in the BM group [29.98 +/- 8.51 vs. 24.50 + 6.19] [p= 0.013]. The leak fraction showed no difference between the devices and it ranged from 5.5-20% and 5-20% in the BM and PLM group respectively. All other studied parameters showed insignificant differences between the two devices. BM takes significantly shorter placement time and provides a better seal as compared to PLM

unnoticed broken sheathed metallic stylet in an endotracheal tube: a case report

We report a 58-years old patient, who underwent surgery for a fracture to the neck of the femur. Tracheal intubation was performed with the aid of a stylet; however, 15 minutes later, it was brought to the notice of the attending anesthesiologist that a broken piece of stylet had been left inside the lumen of the endotracheal tube. Prior to this, there was no evidence of a foreign body in the endotracheal tube or tracheobronchial tree. The broken piece of stylet was successfully retrieved with the help of a Kocher's forceps

Fentanyl and midazolam induced respiratory arrest and neuromuscular paralysis during day care surgery: a case report

We report a 44 year-old, American Society of Anesthesiologist Class I [ASA I], female patient scheduled for elective excision of a small lipoma of the left thigh. She went into a 90 minute apnea and complete muscle paralysis as evidenced by the absence of all stimulatory responses by a peripheral nerve stimulator after receiving midazolam [1.0 mg] and fentanyl [100 micro g] intravenously for sedation and analgaesia. The patient made an uneventful recovery after 90 minutes. No cause and effect relationship could be established between the administered drugs and this unusual response