AIRWAY MANAGEMENT IN LATERAL POSITION. COMPARISION BETWEEN CLASSIC LARYNGEAL MASK AIRWAY AND I GEL

Dr. Syed Sufiyan Habeeb, Dr. Greeshma T M, Dr. Habib Rehman A A

Abstract


Introduction – General anaesthesia anaesthesia  is usually induced in supine position. But in some situations we may have to induce general anaesthesia in lateral position. Also in situations where the surgery has started in regional, patient turned to lateral position for surgery, during the course of the procedure the effect of regional anaesthesia may wear off and patient may complain of pain. In the middle of surgery we may not be able to turn patient supine to induce general anaesthesia and for securing airway. In these situations where patients airway has to be secured in lateral position supraglottic airway devices plays a pivotal role as it is inserted blindly into hypopharynx without use of any airway instrumentation. The aim of this study is to compare two different supraglottic airway devices i.e classic LMA and I gel regarding ease of insertion and efficacy of ventilation in lateral position.

 

Methodology – A prospective randomized study was conducted in eighty patients who were posted for various surgical procedures under general ANAESTHESIA were chosen. They were randomly divided into four groups of 20 patients (right lateral position with I gel, right lateral position with classic LMA, left lateral position with I gel, left lateral position with classic LMA). All the patients were induced in their allotted lateral position by randomization and planned supraglottic airway was inserted in that position. Ease of supraglottic device insertion and adverse effects were assessed in all .

 

Results – there was statistical significant difference between supraglottic airway device insertion in right and left lateral positions. (IRL 42+/-10sec, ILL 60 +/-9sec, CRL 48+/-10sec , CLL 66 +/- 8 sec) (p= 0.0020). number of attempts taken for I gel in right lateral position were less than other groups (90% success rate). Trauma was found to be more in I gel group in left lateral position.

 

Conclusion – Insertion of I-gel was significantly easier and more rapid than insertion of CLASSIC LMA. It was easier to insert supraglottic airway device in right lateral position than left lateral position and insertion of I gel was easier compared to classic LMA. Supraglottic device was successfully inserted in all the patients. None of our patients had desaturation. But amount of trauma caused by I gel was more than classic LMA.

 


Keywords


Classical laryngeal mask airway, I-gel, supraglottic airway devices, left and right lateral position.

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