Context:The Proseal LMA(PLMA), which has been designed especially for positive pressure ventilation and protection against aspiration can act as an alternative to Endotracheal Tube (ETT) as an effective airway device for patients undergoing elective Laparoscopic surgeries.Aims:To compare the efficacy and safety of PLMA with ETT in patients undergoing Laparoscopic surgeries under general anaesthesia.Settings and Design:A prospective, randomized study was conducted in a tertiary care teaching hospital with 60 patients of ASA grade I/II undergoing elective Laparoscopic surgery under general anaesthesia. Ethical committee clearance and written consent taken. The patients were randomly divided into two equal groups to the PLMA group (Group S) and to the ETT group (Group C) Heart rate (HR), mean blood pressure (MAP), ETCO2 values, intraoperative complications such as regurgitation- aspiration, and Postoperative complications such as nausea or vomiting, throat soreness and oral injuries were monitored.Results:There was no difference demographically. Insertion success rate was 100% for both the groups. The mean increase in HR was seen all throughout the duration of the surgery to 8 % above the baseline in Group C and to 3% above the baseline in Group S. On comparing the MAP in Group C, there was a increased by 2.5% to 78.300 ± 14.2615 mmHg as compared to an increase by 5% to 76.233 ± 6.2072 mmHg in Group S. EtCO2 showed a rise in both groups after pneumoperitoneum, which returned to baseline values after completion of surgery. Gastric aspirate values showed no difference in each group. Post op complications were seen mainly in Group C with statistical significance.Conclusions:A properly positioned PLMA is a suitable and safe alternative to ETT for airway management in adequately fasted, adult patients undergoing elective Laparoscopic surgeries.
Aims:To evaluate the efficacy of intrathecal isobaric Ropivacaine and its comparison with intrathecal isobaric Bupivacaine in elective inguinal hernia repair surgeries.Settings and Design:A prospective, randomized study was conducted in a tertiary care hospital with 80 patients of ASA grade I-III undergoing elective inguinal hernia repair surgery under spinal anaesthesia. Ethical committee clearance and written consent taken. The patients were randomly divided into two equal groups to the Ropivicaine group (Group R) and to theBupivicaine group (Group B). Parameters observed were onset and duration of sensory and motor block, maximum sensory level achieved degree of motor blockade, two segment regression, and haemodynamic changes.Results:The development of sensory block was faster with Isobaric Ropivicaine (12.1 ± 4.9 minutes) as than isobaric Bupivicaine (13.94 ± 4.52 minutes) but the difference was not statistically significant. Onset of Grade III Motor block was longer with Isobaric Ropivicaine (8.51 ± 3.39 minutes) as compared to isobaric Bupivicaine (8.51 ± 3.39 minutes), but the difference was not statistically significant. Time of Complete Sensory Regression was significantly shorter with Isobaric Ropivicaine (212.69 ± 27.31 minutes) with statistical significance. Time to complete motor recovery was significantly shorter in Ropivacaine group (253.38 ± 27.13 minutes)as compared to Bupivacaine group (258.55 ± 35.81min), with statistical significance. Time to achieve discharge criteria was relatively shorter with Isobaric Ropivicaine. Haemodynamic Parameters did not differ significantly in both the groups during the entire study period.Conclusion:Intrathecal administration of isobaric Ropivacaine (0.75%) 15 mg provides similar quality of spinal anaesthesia but of significantly shorter duration, maintaining similar hemodynamic stability and discharge criteria without significant adverse effects when compared to isobaric Bupivicaine (0.5%) 10 mg.
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