Objective: The 90° rotation technique for inserting the Proseal laryngeal mask airway (PLMA) is reported to be better than the standard index finger insertion technique to improve the insertion success rate. The objective of this study was to evaluate and compare the ease of insertion through the 90° rotation and standard insertion techniques in terms of number of attempts, duration of insertion and occurrence of complications. Methods:One hundred and twenty adult patients were allocated to either a standard technique group or rotation technique group with 60 patients in each. In the rotation technique group, the entire cuff of the PLMA was placed in the patient's mouth in a midline approach without finger insertion, rotated 90° counter-clockwise around the patient's tongue, advanced and rotated back until resistance was felt. Results:The success rate of the rotation technique group at the first insertion attempt was greater than that of the standard index finger insertion technique (98% vs. 78%; p=0.001), and less time for insertion was required (11.88±3.62 s vs. 25.98±10.92 s; p<0.0001). The incidence of post-operative sore throat was lower (15% vs. 38.34%; p=0.0067), and blood staining on the PLMA was less (11.7% vs. 45%; p<0.0001). The increase in the mean arterial pressure was more in the standard technique group. Conclusion:The 90° rotation technique has a higher success rate at first insertion attempt for inserting the ProSeal LMA than the index finger insertion technique with less time for insertion and fewer side effects.Keywords: LMA insertion techniques, 90° rotation technique, airway management, laryngeal masks, ProSeal LMA Amaç: Proseal laringeal maske havayolunun (PLMA) takılma-sında 90° rotasyonla takma tekniğinin başarı oranının standart işaret parmağıyla takma tekniğinden daha yüksek olduğu bildirilmektedir. Bu çalışmanın amacı 90° rotasyonla takma tekniğini ve standart teknikleri, takma girişimi sayısı, işlemin süresi ve komplikasyonlar açısından değerlendirmek ve karşı-laştırmaktır.Yöntemler: Yüz yirmi yetişkin hasta standart teknik grubu veya rotasyon tekniği grubuna, her grupta 60 hasta olacak şekilde dağıtıldı. Rotasyon tekniği grubunda, PLMA kafı tamamen hastanın ağzına parmak sokulmadan orta hat yaklaşımıyla yerleştirildi, hastanın dilinin çevresinde saat yönü tersine 90° döndürüldü, ilerletildi ve direnç hissedilene kadar geri dön-dürüldü. Bulgular:Rotasyon tekniği grubunun ilk girişimdeki başa-rı oranı standart işaret parmağıyla takma tekniğinden daha yüksekti (%98'e karşı %78; p=0,001) ve işlem süresi daha kısaydı (11,88±3,62 sn'ye karşı 25,98±10,92 sn; p<0,0001). Ameliyat sonrası boğaz ağrısı insidansı daha düşüktü (%15'e karşı %38,34; p=0,0067) ve PLMA'da kan lekesi daha azdı (%11,7'ye karşı %45; p<0,0001). Ortalama arter basıncındaki artış, standart teknik grubuna göre daha fazla bulundu.Sonuç: Proseal LMA'nın takılması açısından, 90° rotasyon tekniğinin ilk girişimdeki başarı oranı işaret parmağıyla takma tekniğinden daha yüksekti. İşlem süresi daha kısaydı ve yan etkileri daha azd...

Induction of anesthesia using an inhalation agent remains a fundamental technique due to its rapid induction and emergence. Sevoflurane is preferred over halothane for its faster induction of anesthesia and lesser complications. Studies on sevoflurane in pediatrics have established it as safe and effective. However, its effectiveness in adults is very limited. Hence, this study was conducted to compare the induction and intubating conditions, hemodynamic profiles, and emergence from anesthesia with sevoflurane and halothane in adults and pediatric patients. This randomized clinical study was carried out for a period of 2 years (November 2006–September 2008) in the Anesthesiology Department of a Krishna Institute of Medical Sciences (Deemed to be) University. Eighty patients of American Society of Anesthesiologists Class I and II were randomly assigned to halothane group and sevoflurane group with 40 patients in each group. Patients were induced and intubated with increasing concentrations of halothane from 0.5% to 5% and sevoflurane 1% to 7% in 50% nitrous oxide and 50% oxygen mixture. Recordings of vitals including induction and intubation time, recovery characteristics, and recovery and discharge time was also recorded. There was a statistically significant difference between sevoflurane and halothane in the induction and intubation time indicating that sevoflurane had faster induction and shorter intubation time compared to that of halothane. Patients in halothane group had more incidence of coughing, intolerance, salivation, breathe holding, rigidity, and movement as compared to sevoflurane group. The mean time to consciousness, response to verbal commands, orientation, and recovery room discharge time was significantly shorter in sevoflurane group as compared to halothane group. Sevoflurane can be a suitable alternative to halothane for induction of anesthesia in patients with a shorter induction and intubation time with better hemodynamic stability. This study was approved by the Institutional Ethics Committee (KIMSDU/IEC-307/028/14/11/2006).

BACKGROUNDThe I-gel is a supraglottic airway device with soft gel like non-inflatable cuff. Compared to Classical LMA, I-GEL does not require cuff inflation. I-gel works in harmony with the patient's anatomy, so that compression and displacement trauma are significantly reduced. LMA and I-gel are supraglottic airways compared to Endotracheal Tube (ETT), which is inserted inside the trachea. This study was done to determine the: 1. Intraocular pressure and 2. Haemodynamic response and compare it between I-gel insertion, classical LMA insertion and laryngoscopy with endotracheal intubation.

The I-gel is genuinely interesting second era aviation route gadget with delicate gel like non inflatable sleeve. The objective of this study was to evaluate and compare the ease of insertion and number of insertion attempts, airway sealing pressure, and evaluation of device position and occurrence of complication. Total70 adult patients were allocated to either i-gel group or P-LMA group with 35patients in each group. Both i-gel and P- LMA were introduced with standard technique. The outcomes measured ease of insertion, number of insertion attempts, airway sealing pressure, changes, evaluation of device position and complications. the i-gel group the success rate at ease of insertion was greater (97% vs72% respectively;P=0.012). Airway sealing pressure was lesser (24.72±1.37 cmH2Ovs 30.09±2.64 cmH2O respectively; P=0.0003). The incidence of postoperative sore throat was lower (2.8% vs 25.7% respectively;P=0.01). Changes in parameters were not clinically significant. The i-gel is easier to insert than P-LMA however with a lower airway sealing pressure. It has a lower incidence of postoperative complications.