Laryngeal mask airway as an alternative to face mask during paediatric fiberoptic bronchoscopy

The aim of this study was to evaluate the usefulness of the laryngeal mask airway [LMA] as an alternative to face mask [FM] during fiberoptic bronchoscopy in pediatric patients. Fifty pediatric patients scheduled for fiberoptic bronchoscopy [FOB] were divided into two groups: Group 1 using LMA and group 2 using face mask for the insertion of fiberoptic bronchoscope through the bronchoscope T-tube adaptor. All patients were pre-medicated and received general anesthesia. It was found that heart rate [HR] was increased and oxygen saturation was decreased during FOB insertion. The insertion time, number of trials and the need for muscle relaxants were higher in face mask group than in LMA group. The incidence of complications as hypoxia, laryngospasm, bronchospasm, coughing was insignificantly higher in FM group

Comparative study between st and ard epidural and combined spinal epidural either with fentanyl or fentanyl and bupivacaine for labour analgesia

We carried out an observational study to assess maternal satisfaction with st and ard epidural and combined spinal epidural [CSE]. We selected 60 nulliparous fullterm parturients who were in active labour and requested analgesia. They were divided into 3 groups For [group 1] st and ard epidural analgesia [10 ml of 0.25%] bupivacaine was injected into the epidural space followed by top-up of 10 ml of 0.125% bupivacaine as required. [Group 2], combined spinal-epidural fentanyl [CSEF] the initial dose was 25 micro g fentanyl in 2 ml normal saline followed by top - up of 25 micro g fentanyl in 5 ml in epidural catheter as required. [Group 3] combined spinal-epidural bupivacaine and fentanyl [mixed CSE], the initial intrathecal dose was 2.5 mg bupivacaine and fentanyl 25 micro g in 2ml normal saline, followed by top-up of 20 micro g fentanyl with 0.125% bupivacaine in 10 ml in epidural space as required. We found that the overall satisfaction was geater in the combined spinal-epidural groups than the st and ard epidural group. Good analgesia was achieved in all groups, but the combined spinal-epidural bupivacaine and fentanyl had faster onset and prolonged duration followed by combined spinal-epidural fentanyl and then st and ard epidural group, The leg weakness was more in st and ard epidural group and very mild in group 3 but absent in group 2. Overall, women seem to be satisfied with low dose combined spinal-epidural fentanyl and bupivacaine perhaps because of the faster onset, less motor blockade and feelings of greater self control