Garpagalakshmi, S (2019) A Comparative Study of Baska Mask and Proseal Laryngeal Mask for General Anaesthesia with Intermittent Positive Pressure Ventilation. Masters thesis, Stanley Medical College, Chennai.
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Abstract
Airway management devices that are placed above the glottis and allow gases to enter and exit the airway are referred to as “Supraglottic airway devices”. They provide a bridge between facemask and tracheal tube in terms of anatomical position and degree of invasiveness[12]. Most supraglottic airway devices (SADs) are designed for use during routine anaesthesia, but there are other roles such as airway rescue after failed tracheal intubation, use as a conduit to facilitate tracheal intubation and use by primary responders at cardiac arrest or other out-of-hospital emergencies. Supraglottic airway devices (SAD) play an important role in the management of patients with difficult airways. Therefore, the use of the LMA is now included in many difficult airway guidelines. The American Society of Anaesthesiologists includes the LMA as a ventilatory device at two points in the algorithm: first in the anaesthetised patient whose trachea cannot be intubated (anaesthetised non-emergency limb); and second in the anaesthetised patient whose trachea cannot be intubated and whose lungs cannot be conventionally ventilated (anaesthetised emergency limb). AIM OF THE STUDY: To compare the sealing pressure of the Bask mask with Proseal laryngeal mask in adult patients undergoing elective surgeries under general anaesthesia with intermittent positive pressure ventilation. OBJECTIVES: 1. To determine the Airway sealing pressure at 5mins, 30mins post placement and at the end of surgery. 2. To determine the Insertion time, number of attempts, ease of insertion, Post-operative laryngopharyngeal morbidity of the supraglottic airway device in the study population. MATERIALS AND METHODS: This was a prospective randomized study done on patients undergoing elective surgeries in the Department of Anaesthesiology, Stanley Medical College, Chennai. After obtaining the approval of the Institutional Ethical Committee, a randomized, prospective study was conducted on 70 patients over a period of six months. SAMPLE SIZE: In a study conducted by Sharifa Ali Sabeeh Al-Rawahi et al[31] the mean airway sealing pressure was 29.98±8.51 in Baska mask group ( n= 30) and 24.50±6.19 in Pro-seal group (n=22). To detect similar difference in means with 80% power, a sample size of 70 (35 in each group) was calculated with n Master software Version 2.0 by applying the following formula. INCLUSION CRITERIA: All consented adult patients aged between 18 – 65 yrs belonging to ASA physical status I - II undergoing elective surgical procedures requiring general anaesthesia with Intermittent positive pressure ventilation of less than 2 hours duration. EXCLUSION CRITERIA: • Anticipated difficult airway. • Mouth opening of < 2.5 cm. • Increased risk of aspiration (Pregnancy, BMI > 30, GERD, hiatus hernia). • Patients with increased airway resistance and decreased lung compliance (obstructive and restrictive lung diseases). • Requiring surgery in the non-supine position. • Patient refusal. FINDINGS: A Prospective randomized control study for six months of seventy patients using Baska mask (n=35, 50%) and Proseal Laryngeal Mask (n=35, 50%) revealed the following results. SUMMARY: The following observations were made in our study. 1. Baska mask provides superior airway sealing (higher OLP) compared to Proseal LMA. 2. The insertion time was significantly lower for Baska mask and Baska mask was easy to insert. 3. Insertion characteristics like number of attempts, number of manipulations were similar between both the groups. 4. Incidences of blood staining of the device after removal was higher in Baska mask compared to LMA ProSeal. 5. The postoperative Laryngopharyngeal morbidity scores were higher in PLM group in anesthetized adult patients. CONCLUSION: In our study we conclude that Baska mask can be used as an alternative for second generation Proseal LMA because of its safety profile in terms of higher sealing pressure, shorter insertion time, greater ease of insertion with lesser emergence complications and postoperative laryngopharyngeal morbidity compared to Proseal LMA.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Baska Mask and Proseal Laryngeal Mask, General Anaesthesia, Intermittent Positive Pressure Ventilation. |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Subramani R |
| Date Deposited: | 19 Aug 2019 01:08 |
| Last Modified: | 19 Aug 2019 01:08 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/11040 |
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