BACKGROUND & METHODS This study was conducted to determine and compare the pressor responses associated with insertion of a laryngeal mask airway with endotracheal tube during elective surgical procedures under general anaesthesia in paediatric patients. 64 patients of age between 2-12 years weighing between 10-40 kg, belonging to ASA grade I and II, scheduled for elective surgeries under general anaesthesia were included in the study. Patients belonging to ASA grade III and IV, those scheduled for emergency surgeries and patients with anticipated difficult airway were excluded from the study. The patients were randomised into two groups of 32 each, by computer generated software. For patients in group-L, airway was secured with laryngeal mask airway. Patients in group-E, airway was secured with endotracheal tube. Heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and SpO2 were recorded just before induction and subsequently at 1, 3, 5 & 10 minutes. Mean heart rate increase at 1, 3 & 5 minutes was much less when compared to Group-E (p=significant). Mean systolic blood pressure of Group-L is significantly less at 1, 3, 5 & 10 minutes than that of Group-E (p=significant). Mean diastolic blood pressure of Group-L is significantly less at 1, 3 & 10 minutes compared to Group-E (p=significant). RESULTS & CONCLUSION Complications like sore throat, blood staining and coughing at the end of the procedure were seen less in Group-L than in group-E. In this study, we concluded that the pressor responses were less with LMA than with endotracheal tube. Based on our conclusion, we can say that LMA can be used as an alternative to endotracheal tube in maintaining an intact airway under general anaesthesia.

Maxillofacial procedure such as LeFort I osteotomy requires Transmyelohyoid Intubation. For that initial intubation is done with Flexometallic Endotracheal Tube so that this tube can be easily brought out through transmyelohyoid incision. Frequently Flexometallic tubes are reused after Ethylene Oxide Sterilisation because of high Cost. Here we present an obstruction to endotracheal tube at an unusual location, (Deformity of the tube at the level of Cuff, with intact cuff).

Background and Aims: Inability to intubate trachea is one of the most important cause of Anaesthesia related mortality and hypoxic brain injury. Various pre-operative tests were devised for prediction of difficult intubation but have variable positive predictive value, sensitivity and specificity. We aimed to compare the commonly used predictive tests Modified Mallampati test, Thyromental Distance and Neck circumference to assess the predict difficult intubation, individually and in combination. Material and Methods: 115 adult patients of ASA 1 & 2 undergoing elective general surgical procedures under general anaesthesia with endotracheal intubation in a Medical College Hospital were the subjects in this study. Patients airway were assessed by modified Mallampati test, neck circumference and thyromental distance. Patients in whom fibre optic intubation was planned were excluded. Difficulty in Intubation was assessed by Cormack and Lehane's grading. Which is the gold standard to assess difficulty in intubation. Results: Modified Mallampati Test has specificity of 61.54% and Sensitivity of 86.14% . Thyromental Distance has a specificity of 61.54% and Sensitivity 42.57%. Neck circumference has a specificity of 15.38% and Sensitivity of 100%. When all the three tests combined specificity increased to 82.3% and Sensitivity increased to 100%. Conclusion: By combining the three p predictors we can increase the sensitivity and specificity of prediction there by reducing false arms about difficult intubation and increase the true positive difficult intubation so that advanced airway management equipments can be kept ready.