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Comparison of Laryngoscopic View and Hemodynamic Changes with Flexitip McCoy and Macintosh Laryngoscope Blade in Predicted Easy and Difficult Airway

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Open Journal of Anesthesiology 2013年第5期3卷 278-282页

作者： Zia Arshad Haider Abbas Jaishree Bogra sulekha saxena Department of Anesthesiology K G Medical University Lucknow India.

Objective: To compare the laryngoscopic view and the hemodynamic changes by using flexitip McCoy laryngoscope with Macintosh laryngoscope. Method: Study design-Prospective randomized controlled study. A total of 220 patients were included in the study. Patients were allocated on the basis of their airway anatomy in to two groups, one is predicted easy group and the other one was predicted difficult airway group. Among each group, half of the patient intubation was performed with Macintosh blade and the other half was intubated with the help of McCoy blade. The airway prediction was done on the basis of Mallampati grade, thyromental distance, inter incisor gap, jaw protrusion and weight of the patient. Larygoscopic view and hemodynamic changes were recorded. Results: The change in pulse rate was significantly (p = 0.01) higher among the patients of Group B (85.02 ± 10.13) as compared to Group A (79.20 ± 13.11) after induction in predicted easy patients. Similar observation was found for pulse rate after laryngoscopy among both predicted easy and difficult patients. The diastolic blood pressure was significantly (p = 0.0001) higher in Group B (86.34 ± 9.78) than Group A (77.12 ± 11.66) after induction among predicted easy patients. However, diastolic blood pressure was significantly (p = 0.0004) higher in Group A (82.00 ± 10.98) compared with Group B (75.00 ± 9.06) after induction among predicted difficult patients. The average time taken during laryngoscopy was in-significantly (p > 0.05) higher in Group B (13.90 ± 5.95) compared with Group A (12.42 ± 3.58) among predicted easy patients. However, the time taken was significantly (p = 0.0001) higher in Group A (20.83 ± 2.47) than Group B (12.66 ± 3.0) in predicted difficult patients. A majority of the patients of both the groups were in Grade I (Group A = 61.8%, Group B = 81.8%) followed by Grade II (Group A = 38.2%, Group B = 18.2%) among predicted easy patients. Conclusion: It was concluded that the McCoy blade may

关键词： Macintosh Blade McCoy Blade Laryngoscopy Airway

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Management of Airway in a Patient with Traumatic Sub-glottic Stenosis

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Open Journal of Anesthesiology 2013年第3期3卷 199-200页

作者： Zia Arshad Haider Abbas sulekha saxena Jaishri Bogra Department of Anaesthesia KG’s MU Lucknow India.

Tracheal stenosis or tracheal injury is a distressing condition. The silicone tracheal T-tube presents a substitute for stent of this complicated disease. We have come across a case of tracheal perforation in which tracheoplasty was planned. After traceoplasty silicone tracheal T-tube was placed as a stent. We were not able to connect silicone tracheal T-tube with Bain circuit with ET TUBE No. 8.5, 8, 7.5, 7 connector and it was difficult to ventilate the patient now. We have tried other ET TUBE connector and finally we succeeded to connect ET TUBE No. 5.5 connector with Bain circuit and we were able to ventilate the patient.

关键词： Traceoplasty Tracheal T-Tube Subglottic Stenosis

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The Effect of Intraperitoneal Ropivacaine for Post-Operative Pain Management in Patients Undergoing Laparoscopic Cholecystectomy: A Prospective Double-Blind Randomized Control Study

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Open Journal of Anesthesiology 2013年第3期3卷 193-198页

作者： Dinesh Singh Jaishri Bogra sulekha saxena Ajay Chaudhary Shashi Bhusan Girish Chandra Department of Anaesthesia KG’s MU Lucknow India.

Objective: To compare the effect of intraperitoneal ropivacaine with placebo for post-operative pain management in patients undergoing laparoscopic cholecystectomy. Material and Methods: All patients were pre-medicated with glycopyrrolate 0.2 mg, ondansetron 4 mg and ranitidine 150 mg intravenously half an hour prior to induction of anesthesia. All patients were given standard general anaesthesia with propofol (2-2.5 mg/kg), fentanyl 2 μg/kg, and succinylcholine (2 mg/kg) to facilitate tracheal intubation. Anesthesia was maintained with 60% N2O in oxygen with 0.5% to 1% Halothane. Group A: Patients received 20 ml of 0.9% normal saline as placebo (n = 25). Group B: Patients received 20 ml of 0.5% ropivacaine (n = 25). Results: The age and sex distribution of both the groups was similar. The heart rate, systolic & diastolic blood pressure, mean blood pressure and mean trend of SpO2 in both groups remained similar over the periods. The mean VAS varied considerably within (between time) and between the groups (treatment) and was especially comparatively higher in Group A at initial hours 15 min to 30 min and at end hours 12-24 hrs as compared with Group B. On an average, the frequent dosing of rescue analgesia and mean No. of rescue analgesia doses were higher in Group A followed by Group B. In both groups, the treatment related adverse events were mostly emetic symptoms and shoulder pain with the highest being in Group A. Conclusion: We conclude that intraperitoneal instillation of local anaesthetic is an easy, cheap, and non-invasive method which provides good analgesia in the immediate postoperative period after laparoscopic surgery.

关键词： Intraperitoneal Bupivacaine Cholecystectomy Anaesthetic

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