Objective: The 90° rotation technique for inserting the Proseal laryngeal mask airway (PLMA) is reported to be better than the standard index finger insertion technique to improve the insertion success rate. The objective of this study was to evaluate and compare the ease of insertion through the 90° rotation and standard insertion techniques in terms of number of attempts, duration of insertion and occurrence of complications. Methods:One hundred and twenty adult patients were allocated to either a standard technique group or rotation technique group with 60 patients in each. In the rotation technique group, the entire cuff of the PLMA was placed in the patient's mouth in a midline approach without finger insertion, rotated 90° counter-clockwise around the patient's tongue, advanced and rotated back until resistance was felt. Results:The success rate of the rotation technique group at the first insertion attempt was greater than that of the standard index finger insertion technique (98% vs. 78%; p=0.001), and less time for insertion was required (11.88±3.62 s vs. 25.98±10.92 s; p<0.0001). The incidence of post-operative sore throat was lower (15% vs. 38.34%; p=0.0067), and blood staining on the PLMA was less (11.7% vs. 45%; p<0.0001). The increase in the mean arterial pressure was more in the standard technique group. Conclusion:The 90° rotation technique has a higher success rate at first insertion attempt for inserting the ProSeal LMA than the index finger insertion technique with less time for insertion and fewer side effects.Keywords: LMA insertion techniques, 90° rotation technique, airway management, laryngeal masks, ProSeal LMA Amaç: Proseal laringeal maske havayolunun (PLMA) takılma-sında 90° rotasyonla takma tekniğinin başarı oranının standart işaret parmağıyla takma tekniğinden daha yüksek olduğu bildirilmektedir. Bu çalışmanın amacı 90° rotasyonla takma tekniğini ve standart teknikleri, takma girişimi sayısı, işlemin süresi ve komplikasyonlar açısından değerlendirmek ve karşı-laştırmaktır.Yöntemler: Yüz yirmi yetişkin hasta standart teknik grubu veya rotasyon tekniği grubuna, her grupta 60 hasta olacak şekilde dağıtıldı. Rotasyon tekniği grubunda, PLMA kafı tamamen hastanın ağzına parmak sokulmadan orta hat yaklaşımıyla yerleştirildi, hastanın dilinin çevresinde saat yönü tersine 90° döndürüldü, ilerletildi ve direnç hissedilene kadar geri dön-dürüldü. Bulgular:Rotasyon tekniği grubunun ilk girişimdeki başa-rı oranı standart işaret parmağıyla takma tekniğinden daha yüksekti (%98'e karşı %78; p=0,001) ve işlem süresi daha kısaydı (11,88±3,62 sn'ye karşı 25,98±10,92 sn; p<0,0001). Ameliyat sonrası boğaz ağrısı insidansı daha düşüktü (%15'e karşı %38,34; p=0,0067) ve PLMA'da kan lekesi daha azdı (%11,7'ye karşı %45; p<0,0001). Ortalama arter basıncındaki artış, standart teknik grubuna göre daha fazla bulundu.Sonuç: Proseal LMA'nın takılması açısından, 90° rotasyon tekniğinin ilk girişimdeki başarı oranı işaret parmağıyla takma tekniğinden daha yüksekti. İşlem süresi daha kısaydı ve yan etkileri daha azd...
Introduction: Arthroscopy for knee surgery is the most often used minimally invasive orthopaedic surgical technique. Postoperative discomfort can be caused by irritation to the nerve endings in the synovial tissue, the fat pad in the front of the knee, and the joint capsule that can take place during the excision and resection. Aim: To compare the efficacy of Intra-Articular (IA) dexmedetomidine versus buprenorphine for postoperative analgesia following arthroscopic knee surgeries. Materials and Methods: A prospective interventional study was carried out for a period of one and a half years from January 2021 to June 2022 at Department of Anaesthesiology B.L.D.E. (Deemed to be University) Shri B.M. Patil Medical College, Hospital and Research Centre, Vijayapura, Karnataka, India. Around 80 patients of both genders of American Society of Anaesthesiologists (ASA) grade I and II who were scheduled for arthroscopic knee surgeries were randomly divided into two equal groups of 40 each. After the operation was finished, the patients in each group received the respective medications intra-articularly through an arthroscopy port. Group D received Inj. Dexmedetomidine 100 mcg+ Inj. Bupivacaine 0.25%, 20 mL. Injections of buprenorphine 100 mcg and bupivacaine at a concentration of 0.25% , 20 mL were given to the participants in group B. Immediately following surgery, the patient’s temperature, pulse, Mean Arterial Pressure (MAP), and Visual Analogue Scale (VAS) score for pain were all monitored and recorded at the 1st, 2nd, 4th, 8th, 12th and 24th hour. Time to first rescue analgesia, the number of patients requiring rescue analgesia within the next 24 h, the visual analog scale at rest, and on mobilisation at 1st, 2nd, 4th, 8th, 12th, and 24 hour were measured. Side-effects like sedation, pruritis, nausea, vomiting, respiratory depression, and hypotension were also monitored. Descriptive statistics were reported as mean (SD) for continuous variables, and frequencies (percentage) for categorical variables. Data were statistically evaluated with IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, Version 26.0, IBM Corp., Chicago, IL. Results: The mean age of the study participants was 38.38±11.30 years among the buprenorphine group and 36.40±12.07 years among the Dexmedetomidine group. Among the Buprenorphine group 52.5% were females and 47.5% were males. There was a statistically significant difference in VAS score at rest and mobilisation between the groups. The mean time for first rescue analgesia was longer for the buprenorphine group 1016.22±137.54 minutes and for the dexmedetomidine group, it was 523.67±117.47 minutes. Rescue analgesia was given to 9 (22.5%) in the buprenorphine and 18 (45%) in the dexmedetomidine group. Conclusion: In comparison to IA dexmedetomidine, buprenorphine produces analgesia for a longer period of time and reduces the amount of postoperative rescue analgesic that is required.
BACKGROUND Dilated cardiomyopathy (DCM) is a form of cardiomyopathy characterised by left ventricular or biventricular dilatation and impaired ventricular contractility. Peripartum cardiomyopathy (PPCM) is a disease affecting the parturient during late pregnancy or immediately after delivery. It has an incidence of one per 3500 live births and is associated with a high mortality rate (30-60%). [1] The major concern while managing these patients is to optimise fluid administration and avoid myocardial depression, while maintaining stable intraoperative haemodynamics. Seizure disorders are 2 nd most prevalent and most serious neurological conditions encountered in pregnant women after migraine. Epilepsy can affect the course of pregnancy, labour, delivery and alter the foetal development whereas pregnancy can exacerbate epilepsy. [2,3] Metabolism of antiepileptic medications during pregnancy is changed and teratogenic effects of several anticonvulsant medications are unquestioned. Anaesthetic management of such cases poses a challenge due to the increased risk of various perioperative complications. We report the successful anaesthetic management of a patient with PPCM and seizure disorder posted for Suction Evacuation with Sterilisation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.