Indian journal of anaesthesia
-
A fixed dose of propofol administered rapidly can be insufficient or in excess resulting in airway complications and haemodynamic disturbances. This study is designed to assess whether loss of motor response to jaw thrust can be a reliable clinical indicator of anaesthetic depth for laryngeal mask airway (LMA) insertion. ⋯ Loss of motor response to jaw thrust provides satisfactory LMA insertion conditions.
-
Optimal depth of endotracheal tube (ET) placement has been a serious concern because of the complications associated with its malposition. ⋯ Fixing the tube at recommended 23 cm in males and 21 cm in females will lead to carinal stimulation or endobronchial placement in many Indian patients. The lip to carina distance best correlates with patient's height. Positioning the ET tip 4 cm above carina as recommended will result in placement of tube cuff inside cricoid ring with currently available tubes. Optimal depth of ET placement can be estimated by the formula "(Height in cm/7)-2.5."
-
In recent years, we have seen a surge in introduction of newer devices with new technology for management of difficult airway. These devices have made our management procedures easier and safer. In the absence of availability of these devices earlier, anaesthetists had developed specific clinical skills to manage these situations, which have been passed on from one generation to the other as table side teaching. ⋯ They are expensive and may not be affordable for most of our institutions and may not be available in all the hospitals in our country. These devices are new addition to our armamentarium, not as substitute but a complement to our clinical skills. Now, the question is how the usage of these devices has affected our clinical practice pattern and do these devices have any limitations? Let's try to understand.
-
A meta-analysis was performed on prospective randomised controlled trials to assess whether the laryngeal mask airway (LMA) offered any advantage over the conventional endotracheal tube in the paediatric age group. Using the Cochrane methodology, a literature search was carried out through peer-reviewed indexed journals in three medical databases to obtain all publications comparing the LMA with the endotracheal tube in the paediatric age group (age less than 12 years), available till December 2010. Data from 16 randomised controlled clinical trials were selected for analysis. ⋯ The LMA was seen to have three advantages over the tracheal tube in the form of lower incidence of cough during emergence, lower incidence of postoperative sore throat and lower incidence of postoperative vomiting (P<0.05). It was seen to offer no advantage over the tracheal tube in incidence of bronchospasm or laryngospasm during emergence; also, it did not offer any advantage in increasing the efficacy of the airway seal. The only disadvantage the LMA had over the tracheal tube was its greater incidence of placement failure in the first attempt.