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Article
ANESTHESIA USING LARYNGEAL MASK AIRWAY FOR INTRA-NASAL SURGERY; A COMPARATIVE STUDY

Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 1 Pages: 43-49
Publisher: Basrah University جامعة البصرة

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Abstract

The purpose of the study was to compare the suitability and safety of the laryngeal mask airway (LMA), for intranasal surgery (INS) anesthesia, with endotracheal tube (ET) anesthesia.we studied 65 patients (ASA grade I and II, according to American Society of Anesthesia classification), aged (18-39) years. The study population was scheduled for elective intranasal surgery. The patients were randomly assigned into two groups: the first group (33 patients), a laryngeal mask airway (LMA Group) was inserted under propofol , fentanyl and muscle relaxant (atracrium), anesthesia was maintained by using a mixture of halothane in N2O/O2. The second Group (32 patients), an endotracheal tube (ET Group) was inserted under propofol, fentanyl and muscle relaxant (atracrium), anesthesia was maintained with a mixture of halothane in N2O/O2.All complications concerning airway insertion, removal or interruption of surgery for compromised airway and ventilation were recorded. Mean blood pressure, heart rate and pulse oxymetry, were continuously monitored and recorded before and after induction and airway device insertion, followed by 10 minutes intervals. Data were analyzed using chi square statistical test; Null hypothesis was rejected at P> 0.05.In LMA Group, there were no episodes of post removal laryngospasm. The incidence of oxyhemoglobine desaturation at removal was significantly reduced compared with that in ET Group (P< O.O2). The number of patients with oxyhemoglobine desaturation less than 92% on airway device removal was 0% in LMA Group, 3 patients (9.375%) in ET Group.In ET Group, the mean blood pressure and heart rate showed significant variation between the different time measurements (P> 0.005). Intubation and extubation resulted in significant transient increase in mean blood pressure and heart rate. In LMA Group, the mean blood pressure was less than baseline value from 1 minute after induction onwards (P< 0.005) and did not show any significant changes during the different time points measurements. LMA application or removal did not cause any significant increase in mean blood pressure or heart rate (P< 0.001).We conclude that using LMA is suitable method for intranasal surgery. It provides a safe, protected airway with a smoother emergence from anesthesia than tracheal intubations. Anesthesia using LMA for intranasal surgery provides a stable circulation.


Article
The Laryngeal Mask Airway: technical guidelines and use in special situations

Author: Ahmed Abdulameer SALIH
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2006 Volume: 5 Issue: 2 Pages: 230-239
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

Summary:Recent advances in airway management have changed the practice of anesthesia. Among these changeshas been the introduction and increasing use of the Laryngeal Mask Airway (LMA). The laryngeal maskairway (LMA) is a novel device that fills the gap in airway management between tracheal intubation anduse of the face mask.This study describes the LMA, different methods of LMA insertion, uses, advantages, problems,complications and contraindications of LMA.During eight years of LMA use in Al-Yarmook teaching hospital in Baghdad, the device was used forwide spectrum of surgical procedures successfully. We report some special series of cases were LMAswere used in providing a patent airway include LMA use with IPPV (intermittent positive pressureventilation), for patient with history of failed intubation, for children who require general anesthesia forultrasonic shock wave lithotripsy, the use of reinforce flexible LMA for nasal surgery and the use of totalintravenous anaesthesia with LMA. Also we describe two methods of blind endotracheal intubationthrough LMA.


Article
The Use of Laryngeal Mask Airway during Anaesthesia for Surgery in the Prone Position in Spontaneously Breathing Patients

Authors: WAJEEH HAMDI AL-ALOUSI --- AHMED ABDULAMEER SALIH
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2006 Volume: 6 Issue: 1 Pages: 65-76
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: The prone position is required for many surgical procedures and maintaining and securing the airway in that position is a major concern for the anesthesiologists. The present study was conducted to evaluate the use of the Laryngeal mask airway (LMA) during anaesthesia in prone position in spontaneously breathing patients.Methods: We describe a prospective study of 40 patients, who ranked in ASA physical status class one and two and required general anaesthesia for surgery in prone position and LMA was used to maintain the airway. Different induction techniques were used and different methods of LMA insertion was used.Results: In 37 patients the LMA was inserted successfully from the first attempt, while in the other three patients there were malpositioned and reposition done successfully. Additional propofol was given to two patients who required deepening of anaesthesia after the LMA could be inserted. No laryngospasm or bleeding from the mouth was recorded. Only one patient vomited once 5 minutes after Extubation, after the protective reflexes had returned well. Conclusions: With experience, appropriate patient selection and good preparations, it is possible to induce and maintain anaesthesia using LMA in spontaneously breathing patients in the prone position.


Article
eamodynamic Changes During Airway Managment in Hypertensive Patients Undergoing Abdominoplasty Surgery

Authors: Ali Abdulhamed Mohamed --- Abbas Mohamed Suhan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 4 Pages: 509-514
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND:Avoidance of heamodynamic changes in hypertensive patients receiving general anesthesia is a goal including patients undergoing abdominoplasty surgery.OBJECTIVE: To compare haemodynamic responses to use of a classic laryngealmask airway (LMA) versus endotracheal tube (ETT) in hypertensive females undergoing abdominoplasty surgery.PATIENT AND METHODS:Place and Duration of study: Al-Amaal private hospital from march. 2012 to march 2014. Fifty hypertensive female patient undergoing abdominoplasty surgery were randomly distrusted into two equal groups using alternate patient technique endotracheal tube( ETT ) and laryngeal mask airway (LMA) ( n=25 each). Patients in both groups were received general anaesthesia using standard anesthetic technique.Patients in ETT group underwent laryngoscopy and ETT intubation, whereas patients in LMA group received LMA without laryngoscopy for their airway maintenance. Haemodynamic variables, (pulse, systolic, diastolic and mean arterial pressures) were measured using non-invasive monitoring technique at various intervals before and after intubation or LMA placement , before and after extubation or LMA removal.CONCLUSION: Laryngeal mask airway provide more stable heamodynaics parameter than endotracheal tube during incertion and removal in hypertensive patients receving general anesthesia for abdominoplasty surgery.

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