Hamidreza Shetabi; Zahra Naserzadeh
Volume 12, Issue 2 , April 2024, , Pages 58-66
Abstract
Objective: Laryngeal mask airway (LMA) insertion has been found to reduce cardiovascular responses whencompared to laryngoscopy and intubation. This research aimed to examine the impact of various techniquesemployed for LMA insertion on cardiovascular response.Methods: This randomized, double-blind clinical ...
Read More
Objective: Laryngeal mask airway (LMA) insertion has been found to reduce cardiovascular responses whencompared to laryngoscopy and intubation. This research aimed to examine the impact of various techniquesemployed for LMA insertion on cardiovascular response.Methods: This randomized, double-blind clinical trial included 90 elective surgery candidates divided intothree groups of 30. All patients underwent similar anesthesia. The LMA was inserted using the classicaltechnique, 180° rotation technique, and face-to-face triple maneuver technique (FFTMT). The cardiovascularresponses, the success rate of LMA placement, and other outcomes were documented and compared amongthe three methods.Results: The study revealed that the blood pressure of patients 10 minutes after LMA insertion using therotational technique was higher than the standard technique (p=0.019). The pulse rate in the third (p=0.044,p=0.024) and fifth minutes (p=0.028, p=0.048) following the insertion of LMA demonstrated higher valueswhen utilizing the FFTMT than the standard and rotational technique groups, respectively. Moreover, theincidence of sore throat following surgery in the FTFTM group was slightly greater than that observed with thestandard and rotation techniques (p=0.389 and p=0.688, respectively).Conclusion: The findings of the present investigation indicated that implementing the classic technique forLMA placement resulted in a more consistent blood pressure (BP) and pulse rate (PR) response than the 180°rotation and FFTMT. Furthermore, the classical method exhibited a marginally lower success rate in terms ofLMA insertion than the alternative methods.
Behnam Hosseini; Faramarz Mosaffa; Shideh Dabir; Hamed Tanghatari; Mehrdad Taheri
Volume 7, Issue 2 , April 2019, , Pages 130-136
Abstract
Objective: To evaluate the evolution pattern of epidural block after rotating the needle tip 45° to the operative side and evaluate its effects on patients’ hemodynamics and recovery profile in those undergoing arthroscopic knee surgery.Methods: Forty participants were randomly subdivided into ...
Read More
Objective: To evaluate the evolution pattern of epidural block after rotating the needle tip 45° to the operative side and evaluate its effects on patients’ hemodynamics and recovery profile in those undergoing arthroscopic knee surgery.Methods: Forty participants were randomly subdivided into control and rotation group (n=20). An 18-gauge, 3.5 inch, Tuohy needle was placed at the level of L4-5 and pushed forward into the epidural space through parasagittal approach, in control group, the needle was pushed forward to the epidural space in cephaldad 90 degrees. For the rotation group, the needle was pushed forward to the epidural space and the tip was rotated 45 degrees to the surgical side.15 mL of bupivacaine 0.5% was injected and evolution of sensory and motor blocks until 2-segment regression of the sensory level below to T10 as well as total duration of motor block and surgery were recorded. Hemodynamic parameters (HR, MAP, and SPO2), hypotension, fluid intake, vasopressors, first ambulation and spontaneous urination were recorded. Statistical analysis was performed using SPSS and P≤0.5 considered significant.Results: Sensory block up to T10 level, Complete motor block and time for 2-segment regression of sensory level were earlier in the 45°-rotation than in the control group (p<0.001).Total duration of motor block in control group was lower than rotation group (p<0.001).Hypotension, N&V, vasopressors and fluid intake showed no statistically difference between the two groups (p=0.219). First spontaneous urination and ambulation were significantly lower in rotation group (p<0.001).Conclusion: 45 degrees’ needle rotation to the surgical side provides a faster block evolution and hastened recovery profile with no significant difference in hemodynamic fluctuations.Clinical trial registry: IRCT20130518013364N7
