Anaesthesia for pan-facial surgeries is challenging because the anaesthesiologist and surgeon have to share the common upper airway field. Oral and nasal routes for intubation are often not feasible. Submental intubation is alternative method to tracheostomy and other modes of intubation for management of airway during maxillofacial surgeries. Aim: To provide safe and easy airway with unobstructed intraoral surgical field without causing much morbidity. Materials and Methods: 30 ASA I and II patients who had pan-facial fracture, including Le Forte II, Le Forte III, with naso-orbital ethmoidal fracture requiring surgical correction admitted in MGM Medical College and MY Hospital Indore were selected for the study. The patients are intubated by submental route and various hemodynamic parameters were evaluated at different time interval during the surgery. In our study, we used two tube method of submental intubation in which another tube was drawn intra oral through submental incision and first tube was replaced. Result: There were no episode of desaturation and no difficulty was encountered in secondary intubation. The average duration of secondary intubation was 3-4 minute (Mean+SD = 3.45+0.95) which is less than the conventional one tube method. Conclusion: As per our experience in study and the review of literature, the submental intubation is very easy and safe method of intubation to provide the unobstructed surgical field for the Le forte II and III panfacial fracture surgeries.

Introduction: LMA has gained popularity as an alternative technique of airway management as compared to endotracheal tube as it is easier and faster to insert than the ETT and cause minimal trauma to the patient's airway. Experimental approach: Total 60 patients scheduled for elective breast surgeries under general anaesthesia were randomly allocated into two groups (LMAS or ETT) comprising 30 each. Parameters like number of attempts, time taken for the insertion of device, haemodynamic response and postoperative complications like sore throat, dysphagia, neck pain etc. were compared between both the devices. Major findings: Intubation at one attempt was found to be higher for the LMAS than ETT, mean time required for ETT insertion was 27.20±2.33 sec which was significantly more than LMA insertion. Use of LMAS resulted in more haemodynamic stability, whereas post-operative complications were seen more with ETT than LMAS. Conclusion: LMA supreme can be more safely and effectively used over ETT for breast surgery as it results in better peri-operative outcomes.

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