End-tidal concentrations of sevoflurane and desflurane for ProSeal laryngeal mask airway removal in anaesthetised adults

Ghai, Babita; Jain, Kajal; Bansal, Dipika; Wig, Jai Dev

doi:10.1097/eja.0b013e328365cad7

Cited by 7 publications

(3 citation statements)

References 21 publications

(26 reference statements)

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“…Clinicians would be much more interested in ED 95 on account of its greater clinical significance. The ED 95 of sevoflurane was obtained by using probit regression analysis which has been applied in literature using Dixon’s up-and-down method [ 40 – 42 ]. However, the method shows the possibility of placing a supraglottic airway device Blockbuster™ without movement response ignoring other parameters (respiratory parameters, BIS and hemodynamic values).…”

Section: Discussionmentioning

confidence: 99%

The optimum sevoflurane concentration for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients: a prospective observational study

et al. 2017

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BackgroundAirway management of the obese patient presenting for surgery is more likely to be a challenging problem. Supraglottic airway device has been adopted as a bridge to connect ventilation and tracheal intubation in obese patients who would be suffered with difficult intubation. The optimum sevoflurane concentration for supraglottic airway device insertion allowing spontaneous breathing in 50% of obese patients (ED50) is not known. The purpose of this study was to determine the ED50 of sevoflurane for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients requiring general anesthesia.MethodsThirty elective obese patients (body mass index 30-50 kg/m2) undergoing bariatric surgery were recruited in this study. The predetermined target sevoflurane concentration (initiating at 2.5% with 0.5% as a step size) was sustained for >5 min using a modified Dixon’s up-and-down method, and then the supraglottic airway device Blockbuster™ was inserted. The patient’s response to supraglottic airway device insertion was classified as either ‘movement’ or ‘no-movement’. The ED50 of sevoflurane were determined by calculating the midpoint concentration of crossover point from ‘movement’ or ‘no-movement’ response.ResultsThe ED50 of sevoflurane for supraglottic airway device Blockbuster™ insertion in obese patients calculated using up-and-down method were 2.50 ± 0.60%. The ED50 and ED95 (95% confidence interval) obtained by probit regression analysis were 2.35 (1.28–3.42) % and 4.03 (3.16–17.83) % for supraglottic airway device Blockbuster™ insertion, respectively.ConclusionWe conclude that the optimum end-tidal sevoflurane concentration required for the supraglottic airway device Blockbuster™ insertion allowing spontaneous breathing in 50% of obese patients (ED50) is 2.5 ± 0.6%.Trial registrationChinese Clinical Trial Registry, ChiCTR-IPR-16009071, Registered on 24 August 2016.

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Section: Discussionmentioning

confidence: 99%

The optimum sevoflurane concentration for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients: a prospective observational study

et al. 2017

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“…The use of a regular LMA may limit the ability to reliably access hypopharynx secretions, and this could have led to falsenegative results in prior studies. The Proseal LMA provides a high seal pressure and a built-in drain tube designed to channel fluid away that easily permits gastric access [18,19]. These characteristics of the Proseal LMA are advantageous for laparoscopic procedures requiring positive pressure ventilation when compared with the regular LMA.…”

Section: Discussionmentioning

confidence: 99%

Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study

Lemos

Oliveira

Cardoso

et al. 2017

Journal of Clinical Anesthesia

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“…The EC 95 of sevoflurane for supraglottic airway device insertion was obtained using probit regression analysis, which has been adopted in literature using Dixon up-and-down method. [ 26 – 28 ] However, the method determines the EC 95 of sevoflurane for successful placing a supraglottic airway device without regard to other parameters (respiratory index, hemodynamic values, and BIS). Therefore, further studies should be adopted to confirm the sevoflurane EC 95 by a comparison with a wider range of concentrations.…”

Section: Discussionmentioning

confidence: 99%

Optimum end-tidal concentration of sevoflurane to facilitate supraglottic airway device insertion with propofol at induction allowing spontaneous respiration in obese patients

Wang

Miao²,

Gao³

et al. 2017

Medicine

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Obese patients are more likely to encounter with difficult airway management, and supraglottic airway device has been adopted to facilitate tracheal intubation. The optimum anesthetic concentration for obese patients to insert a supraglottic airway device with spontaneous respiration has not been investigated. This study was designed to determine the end-tidal concentration of sevoflurane that would provide acceptable condition for supraglottic airway device insertion with propofol at induction in obese patients without using neuromuscular blockade.Thirty elective obese patients [body mass index (BMI) 30–50 kg/m2] scheduled for bariatric surgery were enrolled in this study. Sevoflurane was inhaled at a concentration of 5% after infusion of 1 mg/kg propofol (within 1 minute) according to lean body weight. The target concentration of sevoflurane was initiated at 2.5% with 0.5% as a step size using a modified Dixon up-and-down method. Five minutes after target concentration achieved, the insertion of supraglottic airway device was attempted.The minimum alveolar concentration of sevoflurane for successful insertion of supraglottic airway device calculated using up-and-down method were 2.25 (0.53) % for obese patients. The values of the effective concentration of sevoflurane for successful supraglottic airway device insertion in 50% (EC50) and 95% (EC95) of the obese patients obtained by probit regression analysis were 2.09% (95% confidence interval 1.48–2.68) and 3.31% (95% confidence interval 2.70–8.12), respectively.We conclude that sevoflurane at a minimum alveolar concentration of 2.25% can provide optimal conditions for insertion of supraglottic airway device with spontaneous respiration in obese patients with 1 mg/kg propofol at induction.

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End-tidal concentrations of sevoflurane and desflurane for ProSeal laryngeal mask airway removal in anaesthetised adults

Abstract: Registered with Clinical Trial Registry of India (URL: http://www.ctri.in), Registry ref no: CTRI/2012/12/004285.

Cited by 7 publications

References 21 publications

The optimum sevoflurane concentration for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients: a prospective observational study

The optimum sevoflurane concentration for supraglottic airway device Blockbuster™ insertion with spontaneous breathing in obese patients: a prospective observational study

Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study

Optimum end-tidal concentration of sevoflurane to facilitate supraglottic airway device insertion with propofol at induction allowing spontaneous respiration in obese patients

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