Background: The present study was undertaken to evaluate efficacy of nitroglycerine (NTG) spray for attenuating haemodynamic response to tracheal extubation in normotensive and hypertensive patients.Methods: The study enrolling total 120 ASA I and II patients, (60 normotensive and 60 hypertensive) who had undergone elective surgery under general endotracheal anaesthesia. Both these types of patients were randomly subdivided into two groups of 30 patients each -50% receiving NTG spray and 50% not receiving NTG spray.Results: There was significant increase in heart rate in all four groups after NTG spray. During extubation this increased in heart rate was not statistically significant in group A (Normotensive with NTG) but was significant in group C (hypertensive with NTG) when compared with control groups. Similarly, during extubation there was significant rise in systolic, diastolic and mean arterial blood pressure were noted in all four groups and with use of NTG spray the increase could be significantly attenuated in NTG groups. Increase in heart rate along with reduction in blood pressure seen after NTG spray did not produce significant increase in RPP as compared to hypertensive and normotensive patients who did not receive the NTG spray.Conclusions: Sublingually administered nitroglycerin spray in a dose of 0.8 mg prior to extubation is an effective, practical, easy and relatively safe method in attenuate haemodynamic response to tracheal extubation.
Background: Aim of present study was to compare the efficacy and safety of supraglottic devices (LMA supreme, LMA proseal and I-Gel) by clinical and fiberoptic evaluation in elective laparoscopic surgeries under general anaesthesia with controlled ventilation.Methods: The design was a prospective, randomized study enrolling total 105 patients of either sex, (age 18-65 years), ASA grade I/II and mallampati score I and II, were randomly allocated to LS (LMAS), LP (PLMA), and IG (I-Gel) groups according to the supraglottic device applied. The three devices were compared as regards insertion parameters, adequacy of ventilation (oxygen saturation, endtidal carbon dioxide and air leak), fibreoptic vision and intra or postoperative complications.Results: The overall ease of insertion of LMAS was found to be better than the other two devices. Adequacy of ventilation was comparable in all the study groups. Safety of these devices was found to be comparable but if OLP was considered as a marker of safety of the device, LMA proseal was a better option than the other two devices. There was no significant difference in the fiberoptic view of the laryngeal inlet between the three study groups but the number of patients with grade 4 view of laryngeal inlet fiberoptic was more in I gel than LMA proseal and LMA supreme.Conclusions: It was concluded that the LMAS, PLMA and I-Gel are effective ventilatory devices during controlled ventilation, without major complications. But in clinical practice it is advisable to monitor peak airway pressure, OLP and laparoscopic view of gastric distension whenever these devices are used in laparoscopic surgeries.
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