LMA is a device commonly used in the practice of anesthesia. A condition for insertion of LMA, haemodynamic stability and respiratory depression following induction with Propofol was compared with Thiopentone preceded by topical Lignocaine. The study was a prospective, randomized, comparative study carried out at Victoria, Bowring and Lady Curzons hospitals, Bangalore. Sixty ASA I and II patients undergoing short elective surgical procedures like breast surgeries, minor plastic surgeries, short surgical procedures of upper limb and hernia repair, in patients aged between 16-60yrs, were included in the study. They were randomly allocated into two groups of thirty each. All patients were premedicated with tab. Diazepam, 5mg and tab.Ranitidine, 150 mg, one each in the night and one on the morning of surgery, inj. Glycopyrrolate,0.2mg I.V. and inj.Sufentanil,0.3µgm/kg I.V. Group I received Propofol,2.5mg/kg for induction. Group II received Thiopentone, 5mg/kg for induction preceded by lignocaine spray, 40 mg (4sprays of lignocaine 10% - 10mg/spray to posterior pharyngeal wall).
[...] Tham17 (1995) conducted a randomized single blind study and investigated the incidence of retching during emergence from general anesthesia with a laryngeal mask airway in place. Each patient received fentanyl 1(g/Kg and propofol 2mg/kg for induction. In the control group Lubafax gel surgical lubricant which contains chlorhexidine digluconate) was used to lubricate the posterior aspect of LMA lignocaine gel was used in the test group. The patients were allowed to wake up at the end of surgery with LMA in place and observed for retching. [...]
[...] The study was- “comparison of propofol and thiopentone for Laryngeal Mask insertion”. In this study Propofol was given in a dose of 2.5 mg/kg and Thiopentone 4.0 mg/kg. They found that Propofol is more effective in providing satisfactory condition and that insertion of LMA following induction with Thiopentone resulted in greater incidence of gagging, 0.01 But they also observed that the use of additional induction agent, where necessary, resulted in no ultimate significant difference between the groups for provision of satisfactory conditions. [...]
[...] Our results suggest that thiopentone preceded by topical lignocaine spray provides condition for insertion of LMA comparable to propofol except for Jaw relaxation. Ultimately there was no significant difference between the two groups with respect to number of attempts for insertion or adverse events. There was significant haemodynamic fluctuations and respiratory depression caused by propofol. Thiopentone preceded by topical lignocaine spray is equally good for induction prior to laryngeal mask insertion, as compared to propofol. Thiopentone with lignocaine spray is also more cost effective than propofol. [...]
[...] Concentration in the blood after installation of local anesthetic into airway is nearly same as that follows intravenous injection44 Maximal safe total dosage for topical anesthesia in a healthy 70 kg adult is 300mg for lignocaine. Lignocaine with Epinephrine topically applied, has no significant local anesthesia effect and does not prolong the duration of action of local anesthesia applied to mucous membrane because of poor penetration45. SUFENTANIL46 Structure46-It is a synthetic opioid. It belongs to phenyl-piperidine group. It basically Contains phenyl ring connected by a nitrogen atom to a six member piperidine ring Phenyl group confers high lipophilicity Structure of Sufentanil Pharmacokinetics46 Absorption and distribution: Sufentanil is a synthetic opioid, having a Pka of It is bound to alfa- 1 acid Glycoprotein. [...]
[...] RESULTS Study Design: A prospective, randomized, comparative study consisting of 60 patients allocated into two groups, with 30 patients each, is undertaken to compare the conditions for the insertion of LMA and haemodynamic pattern. Group I consists of 30 patients in whom Propofol was used as an induction agent. Group II consists of 30 patients in whom Thiopentone was used as an induction agent, preceded by lignocaine spray. Comparison of Basic characteristics of the study Basic Group I Group II P value characteristi cs (Mean ( SD) (Mean ( SD) In the present study, age, weight and sex are matched between two groups 0.05 The above table shows that the average age was 31.53 ( 10.11 yrs in group I and 31.43 ( 10.28 yrs in group II.The average weight of the patients were 56.47 ( 8.90 kgs in group I and 55.17 ( 7.92 kgs in group II. [...]
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