Facilitation of laryngeal mask insertion

Stoneham, M. D.; Bree, Stephen; Sneyd, J. R.

doi:10.1111/j.1365-2044.1995.tb06007.x

Cited by 63 publications

(5 citation statements)

References 18 publications

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“…It may do this by inhibiting central betaadrenoceptors [18]. This present study agrees with the earlier findings of Stoneham et al [19] that intravenous lidocaine had no effect on the induction dose of propofol (p = 0.082). Though it had a sedative effect, as reflected by a significantly lower BIS value before propofol administration, this did not translate to a significant reduction in the induction dose of propofol.…”

Section: Discussionsupporting

confidence: 93%

Comparative effects of intravenous esmolol and lidocaine on bispectral index during propofol-fentanyl induction in patients scheduled for elective surgeries under general anaesthesia

Oladosu,

Bolaji,

Ige

et al. 2024

rmj

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INTRODUCTION: Laryngoscopy and endotracheal intubation at induction of anaesthesia have been associated with awareness and haemodynamic fluctuations. Agents that can mitigate these effects should create better anaesthetic conditions. This study aimed to compare the effects of intravenous esmolol and lidocaine on the bispectral index (BIS) and haemodynamic responses during induction of general anaesthesia with propofol/fentanyl in adult patients scheduled for elective surgical procedures. METHODS: This was a prospective randomized controlled study in ninety patients aged 18-65 years who were randomized into three groups to receive either IV esmolol 0.5 mg/kg, IV lidocaine 1.5 mg/kg or normal saline prior to induction of general anaesthesia. RESULTS: The esmolol group had a significantly shorter induction time (p<0.0001) and a lower dose of propofol consumed (p<0.0001) than the lidocaine group. The mean pulse rate was significantly lower at the 1st min to 4th min post-intubation in esmolol and lidocaine groups compared to the control group (p values; 1 min= 0.005, 2 min= 0.008, 3 min= 0.023, 4 min= 0.018). There was a significant difference in the systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in the three groups at 2 min post-intubation. CONCLUSION: Pre-induction intravenous esmolol 0.5 mg/kg was more effective than intravenous lidocaine 1.5 mg/kg in reducing the induction dose of propofol and the induction time. Esmolol also prevented increases in BIS better than lidocaine following endotracheal intubation but both agents were equally effective in attenuating the haemodynamic changes associated with laryngoscopy and endotracheal intubation.

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Section: Discussionsupporting

confidence: 93%

Comparative effects of intravenous esmolol and lidocaine on bispectral index during propofol-fentanyl induction in patients scheduled for elective surgeries under general anaesthesia

Oladosu,

Bolaji,

Ige

et al. 2024

rmj

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“…Propofol generally decrease the incidence of coughing, gagging, and airway irritation [10]. Response to a jaw thrust led to a higher success rate than other previous studies [3,7], but the incidence of laryngospasm or hypoxia (SpO 2 < 90%) was 1.7% and 6.6%, respectively [5]. This may have resulted from the presence of an induction agent in this study.…”

Section: Discussionmentioning

confidence: 70%

“…The weighted syringe drop from the patient's hand [3], verbal command [4], and jaw thrust maneuver [5] were found to be potential indicators of the optimal anesthetic depth for LMA insertion in adults. However, these maneuvers did not provide information about sufficient anesthetic depth for LMA insertion.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the trapezius squeezing test and jaw thrust as indicators for laryngeal mask airway insertion in adults

Chang

Kim

Shim

et al. 2011

Korean J Anesthesiol

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BackgroundThe purpose of this study was to compare the effectiveness of the trapezius squeezing test with that of the jaw thrust maneuver as clinical indicators of adequate conditions for laryngeal mask airway (LMA) insertion in adults under sevoflurane anesthesia.MethodsOne hundred adult patients of ASA physical status 1 or 2 undergoing minor surgical procedures were randomly allocated to the T (trapezius squeezing, n = 50) group or the J (jaw thrust, n = 50) group. The LMA was inserted immediately after the loss of response to trapezius squeezing or jaw thrust. Successful and unsuccessful attempts were recorded. An unsuccessful attempt was defined as the occurrence of coughing, gagging, gross purposeful movements, breath-holding, laryngospasm, or an SpO2 < 90% during LMA insertion. Insertion time, end-tidal sevoflurane concentration, mean arterial pressure, and heart rate were recorded.ResultsThe incidence of successful attempts was significantly higher in the T than in the J group (48/50 vs. 36/50, respectively).ConclusionsThe trapezius squeezing test is a superior indicator of an adequate condition for LMA insertion compared to the jaw thrust maneuver in adults under sevoflurane anesthesia.

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“…However the standard induction dose of propofol does not guarantee optimal insertion conditions as 38% to 60% of patient have shown poor insertion conditions in the previous literature leading to additional doses of propofol causing more hypotension [8][9][10].…”

Section: Discussionmentioning

confidence: 99%

General Anesthesia with Laryngeal Mask Airway: Etomidate VS Propofol for Hemodynamic Stability

Ghafoor¹,

Afshan²,

Kamal³

2012

OJAnes

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Background: Propofol is the most popular induction agent for laryngeal mask airway (LMA) insertion in current anaesthesia practice however associated hypotension has been reported as its major disadvantage. Etomidate, which produces less hypotension, can be considered as an alternative agent for LMA insertion. Objectives: The objective of this study was to compare the hemodynamic effects of etomidate with propofol for induction of general anaesthesia (GA) for LMA. Ease of inserting LMA was also looked at. Material and Methods: It was a prospective randomized double blinded study. All ASA I and II patients of 15 -60 years of age undergoing general anaesthesia with LMA for elective surgeries were included. Patients were induced with intravenous (I/V) fentanyl and induction agent either etomidate or propofol according to group randomization. LMA was inserted after 30 seconds. Intra-operative heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), number of attempts and duration of LMA insertion were monitored. Results: There was no difference in the heart rate between the two groups. A significant drop was found for systolic blood pressure (SBP) in propofol group while diastolic blood pressure (DBP) was decreased in both the groups. In propofol group, successful in-sertion of LMA was achieved on the first attempt in 93.3% of patient as compared to 36.7% in etomidate group. Conclusion: Use of etomidate for induction of laryngeal mask anesthesia can prevent the hypotension following induction; however it may delay the insertion of laryngeal mask airway.

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Facilitation of laryngeal mask insertion

Abstract: SummaryThe effects of pretreatment with lignocaine administered intravenously on the insertion of the laryngeal mask airway were investigated in 80

Cited by 63 publications

References 18 publications

Comparative effects of intravenous esmolol and lidocaine on bispectral index during propofol-fentanyl induction in patients scheduled for elective surgeries under general anaesthesia

Comparative effects of intravenous esmolol and lidocaine on bispectral index during propofol-fentanyl induction in patients scheduled for elective surgeries under general anaesthesia

Comparison of the trapezius squeezing test and jaw thrust as indicators for laryngeal mask airway insertion in adults

General Anesthesia with Laryngeal Mask Airway: Etomidate VS Propofol for Hemodynamic Stability

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