Deepti Saigal

Abstract

Introduction: Oropharyngeal seal pressure of supraglottic device is an important parameter for safe use during laparoscopic surgeries. Aim: To compare the oropharyngeal seal pressure and other insertion characteristics between baska mask and i-gel in adult patients undergoing laparoscopic cholecystectomy. Materials and Methods: Sixty adult patients were randomly allocated into two groups of 30 each. Baska mask was inserted in group B and i-gel was inserted in group I. Primary outcome was oropharyngeal seal pressure. Secondary outcomes were insertion characteristics like first attempt success rate, insertion attempts, duration and maneuverers to achieve effective airway. Results: Oropharyngeal seal pressure was significantly higher at insertion (31.70±3.67 cmHO versus 27.3±2.93 cmHO respectively, p value Conclusion: Baska mask, with a significantly higher oropharyngeal seal pressure, is a better ventilatory device as compared to i-gel in patients undergoing laparoscopic cholecystectomy.   Keywords: Airway management, Oropharyngeal seal pressure, Regurgitation gastric

View Article

Abstract

Introduction: Robot assisted pelvic surgeries are associated with cardiorespiratory changes due to conjunction of carboperitoneum and steep Trendelenburg position for prolonged durations. Aim: To determine the changes in cardiovascular and respiratory systems in patients undergoing elective robot assisted pelvic surgeries under general anesthesia. Materials and Methods: A prospective observational study was conducted in 35 patients scheduled for elective robot assisted pelvic surgeries. Patients belonging to ASA class I and II were included and their intraoperative hemodynamic and respiratory parameters were noted post induction (baseline), at pneumoperitoneum, at and every 15 minutes after steep Trendelenburg positioning, at resuming supine position, at deflation of pneumoperitoneum and post-deflation. Primary outcome was mean arterial pressure. Secondary outcomes were systolic and diastolic blood pressures, heart rate, central venous pressure, airway pressures (peak, plateau and mean), pulmonary compliance, minute ventilation, end tidal carbondioxide levels and blood gas values. Results: On assuming steep Trendelenburg position, there was significant increase in systolic, mean and diastolic blood pressures. There was significant increase in peak, plateau and mean airway pressures and significant decrease in pulmonary compliance which led to increase in end tidal carbondioxide levels and minute ventilation. On resuming supine position and deflation of pneumoperitoneum, there was significant decrease in mean arterial pressure. Although the pulmonary compliance improved, it continued to be significantly lower than the post-induction baseline value. Conclusion: Robot-assisted pelvic surgeries are associated with significant changes in hemodynamic and respiratory parameters of patients.   Keywords: Hemodynamic monitoring, Pneumoperitoneum, Robot­assisted­surgery, Respiratory

View Article