RESUMO
Background and Aims: Intra-cuff pressure of Air-Q self-pressurized laryngeal airways (Air-Q SP) balances airway pressure and adapts to patient's pharyngeal and periglottic structures, thus improves oropharyngeal leak pressure (OLP).This study was performed to compare efficacy of Air-Q SP with Proseal laryngeal mask airway (PLMA) in patients undergoing elective surgery. Material and Methods: The study design was prospective, randomized and controlled. Ninety patients were randomly assigned to Air-Q SP or PLMA group. All patients were premedicated and shifted to operation theatre. Monitoring was instituted. After securing IV-line, induction with inj. Morphine + Propofol, relaxation with inj. Vecuronium was done. Supraglottic was inserted according to group allocation. Outcome measures were OLP, fibreoptic view of larynx, success rate, device insertion parameters, haemodynamic and respiratory parameters and post-operative laryngopharyngeal complications. Neostigmine + glycopyrrolate were given, device was extubated. Results: All supraglottic airway devices (SADs) were successfully placed in two attempts. The mean initial OLP, OLP at 10 minutes, and device insertion time were significantly lower in Air-Q SP group. Fiber-optic laryngeal view grading was significantly better with Air-Q SP. No significant difference was observed with respect to rate of successful insertion in first attempt, ease of insertion, and manipulations required. The hemodynamic/respiratory parameters and post-operative sore throat in the two both groups were similar. Conclusions: Proseal LMA has a higher OLP than Air-Q SP but average insertion time was better, and fiber-optic grading of laryngeal view was shorter with Air-Q SP. However, Air-Q SP and Proseal LMA were both effective for lung ventilation.
RESUMO
BACKGROUND: The angulated C-MAC D-Blade videolaryngoscope (VL) is designed for difficult intubation and may not be compatible with standard PVC endotracheal tubes. OBJECTIVE: Present study was planned to compare efficacy of C-MAC, D-blade VL using endotracheal tube with three different stylets versus No stylet in patients undergoing tracheal intubation with simulated difficult airway. METHODS: After obtaining written consent and IEC approval, total 144 adult patients were allocated to four groups of 36 each using no stylet or different types of stylets. The four groups were Group NS: No stylet; Group CS: C-MAC stylet; Group DS: D-blade type stylet; Group HS: hockey-stick shaped stylet. A rigid appropriate sized Philadelphia cervical collar was placed around the neck to simulate difficult airway and C-MAC D-Blade VL was used for intubation. The duration of each intubation stage and attempts were evaluated. Statistical analysis was performed using SPSS 22.0 for Windows and appropriate tests for different variables were applied. Appropriately, Student's t test, Chi-square test, Mann-Whitney U test and one-way ANOVA test were applied. RESULTS: Similar Cormack Lehane grade glottic view was observed in all groups. The number of attempts and duration of intubation was significantly greater using NS than for other groups. Additional laryngeal manipulation, was required in all cases in Group NS, compared to one, zero and two cases in group CS, DS and HS respectively (p<0.001). CONCLUSION: Use of Hockey stick shaped, D blade shaped stylet and C Mac stylet decreased the total intubation duration in patients with simulated difficult airway.
