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Selvin Caren Candace,Singariya Geeta,Bihani Pooja,Kamal Manoj,Paliwal Naveen,Ujwal Shobha 대한마취통증의학회 2023 Anesthesia and pain medicine Vol.18 No.1
Background: Supraglottic airways (SGA) are increasing used in pediatric anesthesia. Among SGA i-gelTM is commonly used device in pediatric patients. The BlockbusterTM laryngeal mask airway (LMA) is latest addition in pediatric airway armamentarium. This study was conducted to compare the clinical performance of i-gelTM and BlockbusterTM LMA in pediatric patients. Methods: A total of 140 children aged 1–5 years, who were undergoing elective surgery, were randomized into two groups either i-gelTM (Group I) or BlockbusterTM LMA (Group B). Airway was secured with appropriate-sized LMA according to group allocation under general anesthesia. The primary objective of study was oropharyngeal leak pressures (OPLP), and secondary objectives were number of attempts of device insertion, success rate, ease of LMA insertion, hemodynamic parameters, and postoperative pharyngolaryngeal morbidities. Results: The mean OPLP was significantly higher for i-gelTM compared to BlockbusterTM LMA (27.97 ± 1.65 vs. 26.04 ± 2.12; P < 0.000). The devices were successfully inserted on the first attempt in 97.14% and 90% of the i-gelTM group and BlockbusterTM LMA groups respectively. The insertion time, ease of insertion, hemodynamic parameters and postoperative complications were comparable between groups. Conclusions: The i-gelTM was more efficacious device in term of OPLP than BlockbusterTM LMA for positive pressure ventilation in pediatric patients undergoing short surgical procedures under general anesthesia.
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Satya Narayan Seervi,Geeta Singariya,Manoj Kamal,Kamlesh Kumari,Ashwini Siddeshwara,Shobha Ujwal 대한마취통증의학회 2019 Korean Journal of Anesthesiology Vol.72 No.3
Background: The transversus abdominis plane (TAP) block is an effective technique to block the thoracolumbar nerves innervating the anterolateral abdominal wall. This study was conducted to evaluate the analgesic efficacy and opioid consumption with the use of perineural buprenorphine or dexamethasone in TAP blocks after unilateral inguinal hernioplasties. Methods: This prospective, randomized, double-blinded, placebo-controlled study enrolled 93 patients scheduled for unilateral inguinal hernioplasty, followed by an ultrasound-guided TAP block. The participants were randomized into 3 groups (31 patients each). Group L received 20 ml 0.25% levobupivacaine + 1 ml normal saline (NS); group LB, 20 ml 0.25% levobupivacaine + 0.3 mg (1 ml) buprenorphine; and group LD, 20 ml 0.25% levobupivacaine + 4 mg (1 ml) dexamethasone. The patients were observed postoperatively for 24 h for first rescue analgesic requirement, total rescue analgesic consumption, and pain scores on the numeric rating scale (NRS). Results: The time to first rescue analgesic requirement was significantly longer in Group LB than in groups LD and L (688.87 ± 36.11 min, 601.45 ± 39.85 min, and 383.06 ± 36.21 min, respectively; P < 0.001). The mean total tramadol consumption in the first 24 h was the lowest in group LB (P < 0.001, L vs. LB / LD). Groups LB and LD displayed significantly lower NRS scores than group L (P < 0.001 both). Conclusions: Levobupivacaine with perineural buprenorphine in a TAP block after unilateral open inguinal hernioplasty facilitates prolonged analgesia and reduced requirement for rescue analgesics compared to perineural dexamethasone, without significant side effects.
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