ABSTRACT
Background and Aims: Postoperative sore throat (POST) can be as high as 42% in supraglottic devices. LMA® Protector™ is a novel second-generation laryngeal mask airway (LMA) with Cuff Pilot™ technology that allows continuous cuff pressure monitoring. Elevated cuff pressure is a risk factor for POST in supraglottic devices, so we conducted this study to determine whether continuous cuff pressure monitoring can alleviate POST. Methods: This randomised double-blinded clinical trial compared the incidence of sore throat between LMA® Protector™ and LMA® ProSeal™ and was conducted in 118 patients scheduled for elective short surgical procedures. They were randomised to either LMA® Protector™ (Group PT) or LMA® ProSeal™ (Group P). The airway was secured with either of the two devices. The primary outcome was the incidence of sore throat at 1, 6, and 24 hours postoperatively and compared using the Chi-square test along with other parameters like first attempt success rate and blood staining of the device. The time taken for insertion and oropharyngeal seal pressure were compared using an independent t-test. Results: The incidence of POST was low with Group PT (12%) compared to Group P (28.8%) (P = 0.005). The mean oropharyngeal seal pressure was significantly higher in Group PT than in Group P [33.72 (3.07) versus 27.72 (3.88) cm of H2O], P < 0.005. The first attempt success rate was 81.2% and 100% in LMA® Protector™ versus LMA® ProSeal™. Conclusion: LMA® Protector™ had a reduced incidence of POST compared to LMA ProSeal. However, a longer insertion time and difficult placement may be a concern.
ABSTRACT
Glanzmann thrombasthenia (GT) is a congenital disorder inherited autosomal recessively, caused by deficiency of platelet membrane glycoprotein IIb-IIIa complex leading to defective platelet aggregation, and manifesting as mucocutaneous bleeding. Parturients with GT requiring emergency cesarean section are at high risk for perioperative bleeding complications. The anesthetist should be prepared with the necessary measures to control bleeding. This paper presents the successful management of a 23-year-old primigravida with GT undergoing cesarean section in a resource-limited setup where thromboelastography and recombinant factor VIIa (rFVIIa) are not available.
ABSTRACT
Background In this study, we compared Ringer's lactate solution (RL) with PlasmaLyte (PL), a relatively new IV fluid, for perioperative fluid therapy in the pediatric population. Methods This prospective and interventional randomized comparative study was carried out after obtaining clearance from the Institutional Ethics Committee. The study period was from November 2016 to December 2017. Results Hemodynamic parameters such as SpO2, ETCO2, heart rate, blood pressure, temperature, and urine output were stable in both groups throughout the perioperative period without any statistically or clinically significant variations. Children receiving PL (group PL) had better acid-base status, serum electrolytes, and blood lactate profiles compared with children receiving RL (group RL), who had hyponatremia and increased blood lactate levels, which continued to increase in the immediate postoperative period. No significant differences in pH, pCO2, HCO3, serum potassium, serum chloride, blood urea, serum creatinine, or blood sugar were observed. Conclusions PL is better than RL for perioperative fluid therapy in children undergoing abdominal surgeries.