LARYNGEAL MASK AIRWAY PLACEMENT IN CHILDREN: COMPARISION BETWEEN DIFFERENT TECHNIQUES.

Dr Krunal Patel; Dr Kinjal Vaghela

Volume : VII, Issue : XI, November - 2018

LARYNGEAL MASK AIRWAY PLACEMENT IN CHILDREN: COMPARISION BETWEEN DIFFERENT TECHNIQUES.

Dr Krunal Patel, Dr Kinjal Vaghela

Abstract :

Introduction: LMA is effective idge between facemask and endotracheal tube. It does not stimulate the infraglottic structure thus minimizing stress response and airway resistance, associated with fewer cardiovascular and respiratory changes than endotracheal intubation. Inflatable cuff of LMA provides a low pressure seal over glottis and allows positive pressure ventilation. There are 3 technique of insertion: standard (ain), lateral and rotational.

Aims and objective:The aim of study was to evaluate and compare insertion of LMA in child via the standard, the rotational and the lateral approach with the following objectives.

1) Success rate and ease of insertion

� Number of attempts

� Ease of insertion

� Time taken for successful insertion

2) Adverse events during insertion of LMA.

3) Hemodynamic changes

4) Intra and post-operative complication.

Material and methods:

After the approval of ethical committee, 105 ASA grade 1 and 2 patients of age 1-12 years undergoing surgery were included in the surgery and randomly allotted in 3 groups:

Group S (n=35): LMA placement with standard technique

Group R (n=35): LMA placement with rotational technique

Group L (n=35): LMA placement with lateral technique

After achieving standard anaesthesia protocol, LMA was inserted by skilled anaesthesiologist. Time for successful insertion, ease of insertion, number of attempts, adverse events, hemodynamic changes, intra and post-operative complications were noted.

Results:

First attempt success rate is 94% and second attempt success rate is 100% in rotational technique, which is higher than standard and lateral technique. Ease of insertion and less time was taken in rotational technique. Less adverse effects and intra/post-operative complications noted in rotational technique. No statistically significant hemodynamic changes were noted intra and post-operatively.

Conclusion:

Rotational technique is better than standard and lateral technique in terms of first attempt success rate, ease of insertion, time take for insertion and less intra and post-operative complication.