Evaluation of Fastrach Laryngeal Mask Airway as an Alternative to Fiberoptic Bronchoscope to Manage Difficult Airway: A Comparative Study
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 1
Abstract
Introduction: Awake intubation via Fiberoptic Bronchoscope (FB) is the gold standard for management of difficult airway but patients had to face problems like oxygen desaturation, tachycardia, hypertension and anxiety due to awake state. This study was conducted to assess feasibility of Fastrach Laryngeal Mask Airway (FLMA) to manage difficult airway as a conduit for intubation as well as for ventilation. Materials and Methods: After ethical approval and informed consent, 60 patients with difficult airway were randomly enrolled in FB group and FLMA group. In FB group, patients were sedated with midazolam/fentanyl. Airway anaesthetization of oropharynx was done with xylocaine spray and viscous and larynx and trachea by superior laryngeal nerve block and transtracheal block respectively. In FLMA group, initially patients were induced with propofol for FLMA insertion then succinylcholine was given for Tracheal Intubation (TI). The first TI attempt was done blindly via the FLMA and all subsequent attempts were performed with fiberoptic guidance. Haemodynamic monitoring was done during induction, intubation, immediately post insertion and there after at five minutes interval for 30 minutes. Results: All patients in the FLMA group were successfully ventilated (100%). In both the groups 28 (93.33%) patients were successfully intubated. However, first/second/third attempt intubation rate in FLMA vs FB group was 15 (50%) vs 13 (43.3%), 8 (26.66%) vs 10 (33.33%) and 5 (16.66%) in both groups respectively. Patients in the FLMA group were more satisfied with their method of TI and had lesser complications (p<0.05). Conclusion: So the FLMA may be a better technique for management of patients with difficult airways.
Authors and Affiliations
Radhey Shyam, Ajay Kumar Chaudhary, Pushplata Sachan, Prithvi Kumar Singh, Gyan Prakash Singh, Vinod Kumar Bhatia, Girish Chandr, Dinesh Sing
Keywords
Related Articles
- EP ID EP328725
- DOI 10.7860/JCDR/2017/22001.9284
- Views 154
- Downloads 0
CA-19-9 as an Emerging Marker of Ovarian Tumour: A Rare Entity
ABSTRACT Tumour markers are widely used in clinical practice for diagnosis; follow-up, prognosis and to predict recurrence of certain malignancies. Markers for ovarian cancer include CA-125 antigen, CA-15-3 antigen, and...
Fungal Pericarditis due to Aspergillus nidulans: A Rare Case Report
ABSTRACT Disseminated Aspergillosis though rare is usually seen among immunocompromised and neutropenic patients. Aspergillus spp are usually considered to be a laboratory contaminants until its association with the dise...
Pre-analytical Errors at the Chemical Pathology Laboratory of a Teaching Hospital
Introduction: The Chemical Pathology Laboratory at the University Hospital of the West Indies (UHWI) processes specimens received from inpatients, the outpatient department and other medical facilities in Jamaica. Specif...
Surfactant Therapy for Early Onset Pneumonia in Late Preterm and Term Neonates Needing Mechanical Ventilation
Introduction: Pathophysiology of pneumonia involves leakage of plasma proteins into the airways and accumulation of cytokines within the lung. Several in vitro and in vivo studies have demonstrated that this proteinaceou...
Comparison of Cord Blood Lipid Profile in Preterm Small for Gestational Age and Appropriate for Gestational Age Newborns
Introduction: Coronary heart disease is one of the major causes of morbidity and mortality in current era. The roots of this epidemic have been traced to as early as foetal life by foetal origin hypothesis. There are a f...