BACKGROUND: Laryngeal Mask Airway (LMA) placement is now considered a common airway management practice. Although there are many studies which focus on various airway techniques, research regarding difficult LMA placement is limited, particularly for anesthesiologist trainees OBJECTIVE: To assess the effectiveness of Laryngeal Mask Airway (LMA) placement after induction with propofol or thiopentone in one hundred day case urological patients. METHODS: An analytical, non interventional, cross sectional comparative study. Patients were divided into Group A (Propofol Group n=50) received propofol (2.5mg/kg) and Group B (Thiopentone group n=50) received thiopentone sodium (4-6 mg/kg) IV. Management of anaesthesia was identical in both groups. Standard monitoring was including NIBP, pulse oxymetery and ECG was done. Co-induction with done with midazolam 0.1 mg/kg body weight. LMA was inserted after adequate level of anaesthesia and then assessed. The presence of gaging, coughing, laryngospasm and movement were noted , recorded by a colleague anaesthetist who entered the induction room during the two minutes assisted ventilation phase and was not aware of the type of induction agent. Statistical analysis was done by using SPSS version 10. The mean and standard deviation was calculated for age. Frequency of subjects was calculated for gender Lund and stovner assessment scheme. The p value of less than 0.05 was considered significant. RESULTS: Thiopentone was associated with an adverse response in 76% of patients, compared with propofol in 26% (p<0.01). Head movement, Laryngospasm, inadequate jaw relaxation were more common using thiopentone (p<0.05). The quality of anaesthesia according to patients was significantly higher in the propofol group (Group A, 80%) than in thiopentone group (Group B, 30%). CONCLUSION: Adverse responses in Group A were less than Group B. Propofol, therefore is superior to thiopentone as an induction agent for laryngeal mask airway.
Objective: To assess the effectiveness of laryngeal mask airway insertion after induction with propofol or thiopentone in one hundred urological patients. Material and Methods: This study was carried out in the Department of Anaesthesiology Khyber Teaching Hospital Peshawar from January 2007 to June 2007. Hundred urological patients coming for day case surgery were included in the study. Patients were divided in to two groups (A & B) of fifty each. Group A (Propofol Group) received propofol (2.5mg/kg) and Group B (Thiopentone group) received thiopentone sodium (4-6 mg/kg) IV. Management of anaesthesia was identical in both groups. Midazolam 0.03 mg/kg body weight was used for co-induction. Laryngeal mask airway was inserted after adequate level of anaesthesia. The presence of gagging, coughing, laryngospasm and movement was noted and graded. Results: Thiopentone was associated with an adverse response in 76% of patients, compared with propofol in 26% (p<0.01). Head movement, laryngospasm, inadequate jaw relaxation were more common using thiopentone (p<0.05). The quality of anaesthesia according to patients was significantly higher in the propofol group (Group A, 80%) than in thiopentone group (Group B, 30%). Conclusion: Adverse responses in propofol Group were less than thiopentone Group. Propofol, therefore is superior to thiopentone as an induction agent for laryngeal mask airway.
Objective: To compare the preventive effect of prophylactic aminophylline, dexamethasone and placebo in the prevention for postdural puncture headache in adult patients undergoing below umbilicus surgery. Material and Methods: This randomized clinical trial was done at department of anesthesia and Critical care at PIMS hospital, Islamabad from January 2018 to June 2018. Adult cases of 18 -45 years of both genders undergoing below umbilicus surgery were included. All the patients were divided in 3 groups. Group A (Aminophylline) patients received 1.5 mg/kg of IV Aminophylline over 10 minutes, group B (Dexamethasone) patients received 0.1 mg/kg of IV Dexamethasone whereas group C (Placebo) patients received IV saline, 15 minutes before the end of the surgery. The frequency of post dural puncture headache along with complications of therapy was noted at 24 hours and 48 hours of surgery and compared in all three groups. Chi-square test was employed to compare the occurrence of PDPH in all three groups and P-value ≤0.05 was considered as significant. Results: At 24 hours headache was present in 2% of patients in group A, 2% in group D and 10.8% of patients in group P. The frequency of headache was similar in group A and D, but was significantly lesser than placebo group (P = 0.003) at 2 hours. At 48 hours no patient in group A reported headache while headache was present in 7.8% (n=8) of patients in group B and 12.7% (n=13) of patients in group C. The frequency of headache was significantly lesser in group A as compared to group B and C (P = 0.001). Conclusions: Post-dural puncture headache observed to the significantly lesser in patients treated with Aminophylline and Dexamethasone compared to placebo group at 24 hours, while headache was significantly lesser in patients treated with Aminophylline as compared to Dexamethasone and Placebo group.
'/%3e%3cpath fill='%23fff' d='m8.751-17.959 10.11 11.373L3.997-9.844l13.94-6.1-7.692 13.129z'/%3e%3c/svg%3e)
'%3e%3ccircle r='20' fill='%23008'/%3e%3ccircle r='17.5' fill='%23fff'/%3e%3ccircle r='3.5' fill='%23008'/%3e%3cg id='d'%3e%3cg id='c'%3e%3cg id='b'%3e%3cg id='a' fill='%23008'%3e%3ccircle r='.875' transform='rotate(7.5 -8.75 133.5)'/%3e%3cpath d='M0 17.5.6 7 0 2l-.6 5L0 17.5z'/%3e%3c/g%3e%3cuse xlink:href='%23a' transform='rotate(15)'/%3e%3c/g%3e%3cuse xlink:href='%23b' transform='rotate(30)'/%3e%3c/g%3e%3cuse xlink:href='%23c' transform='rotate(60)'/%3e%3c/g%3e%3cuse xlink:href='%23d' transform='rotate(120)'/%3e%3cuse xlink:href='%23d' transform='rotate(-120)'/%3e%3c/g%3e%3c/svg%3e)
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)