English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

Successful insertion of Laryngeal Mask Airway (LMA) ProSeal without any unwanted effects, such as coughing and gagging, requires adequate depth anaesthesia and suppression of the upper airway reflexes. Our prime aim was to study Bispectral Index (BIS) guided conditions for LMA ProSeal insertion comparing Propofol versus Sevoflurane with or without Fentanyl citrate. Materials and Methods: A randomised prospective study was done on 120 unpremedicated ASA grade 1 or 2 patients which were divided into four equal groups as group P – Propofol intravenous induction, group PF Propofol intravenous induction with Fentanyl, group S – Sevoflurane gas induction in 60% nitrous oxide and 40% oxygen and group SF -Sevoflurane gas induction in 60% nitrous oxide and 40% oxygen with Fentanyl. The parameters studied were induction time, insertion time, insertion conditions for LMA ProSeal like jaw opening, ease of insertion, coughing, gagging, laryngospasmairway obstruction and patients movements on a three point scale using six variables. Result: Excellent and satisfactory conditions were in 100% patients in group SF, 90% patients in group PF and 66.7% in group P and S. Conclusions: Overall, group PF is better than SF in having shorter induction time and better hemodynamic stability but insertion conditions were better with group SF as compared to group PF though statistically insignificant. Introduction Laryngeal Mask Airway (LMA) classic introduced in 1981 has defined airway management in a whole new prospective. But it has many loopholes from airway protection point of view, which were overcome by LMA ProSeal. LMA ProSeal was developed and designed by Archie Brain and co-workers in 1990. The LMA Classic TM was launched in the UK and within 3 years of launch in the UK, the device had been used in at least 2 million. In August 1991 the Food and Drug Administration (FDA) approved the LMA as an alternative to the face mask-but not an alternative to the tracheal tube with features which improved the laryngeal seal without increasing pressure on mucosa so injury to mucosa is less. It provides higher airway seal pressures so chances of cuff leakage are less and provides better conditions for positive pressure ventilation. It has a drainage tube to decompress the stomach, set risk of regurgitation and aspiration of gastric contents is less compared to LMA classic. It is simple, safe, less traumatic and non-invasive method for providing adequate anaesthesia. Over the years, it has been found as an effective device for airway management in surgeries. Successful insertion of LMA ProSeal without any unwanted effects, such as coughing and gagging, requires adequate depth anaesthesia and suppression of the upper airway reflexes. Propofol considered the superior intravenous induction agent to achieve the optimum conditions for LMA ProSeal insertion, compared with thiopentone and other intravenous induction agents. The conditions for LMA ProSeal insertion after inhalation induction with Sevoflurane are as good as with Propofol. However, inhalation induction with Sevoflurane, without any co-induction agents produces more excitation before insertion of LMA ProSeal and takes more time to produce jaw relaxation. The objective of this study was to investigate the conditions for LMA ProSeal insertion in unpremedicated patients using high concentration Sevoflurane, vitalcapacity breath induction technique with or without Fentanyl as a co-induction agent, compared with standard Propofol induction with or without Fentanyl taking BIS (Bispectral index) value of 50-45 as a targeted end point for LMA ProSeal insertion. Bispectral analysis is more recent method of EEG analysis. Article Info Received: 11th June, 2019 Accepted: 15th July, 2019 Published Online: 22nd August, 2019

BIS guided conditions for ProSeal laryngeal mask airway insertion – A comparison of Propofol versus sevoflurane with or without fentanyl