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Original Articles
- Comparison of Hemodynamic Changes by the Thoracic Electrical Bioimpedance Device during Endotracheal Intubation or Insertion of Laryngeal Mask Airway in General Anesthesia
- Han Mok You, Jin Mo Kim, Jae Kyu Cheun
- Korean J Crit Care Med. 1998;13(1):67-72.
- 1,707 View
- 7 Download
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Abstract
PDF - Introduction: we measured the hemodynamic changes by the thoracic electrical bioimpedance (TEB) device during induction of anesthesia, endotracheal intubation or insertion of layngeal mask airway (LMA). This TEB device is safe, reliable and estimate continuously and invasively hemodynamic variables.
METHODS
We measured the cardiovascular response of endotracheal intubation or that of LMA insertion in thirty ASA class I patients. General anesthesia was induced with injection of fentany 1 microgram/kg, thiopetal sodium 5 mg/kg and vecuronium 1 mg/kg intravenously. Controlled ventilation was for 3 minutes with inhalation of 50% nitrous oxide and 1.5 vol% of enflurane before tracheal intubation or LMA insertion in all patients. The patient was randomly assinged to either tracheal intubation group (ET group) or laryngeal mask airway group (LMA group). Heart rate (HR), mean arterial pressure (MAP), systemic vascular resistance (SVR), stroke index (SI) and cardic index (CI) were measured to pre-induction, pre-intubation, 1 minute after intubation, 2 minute, 3 minute, 5 minute, 7 minute.
RESULTS
MAP and SVR were decreased effectively LMA group than ET group during 1 minute after intubation, 2 minute, 3 minute, 5 minute, 7 minute (p<0.05). HR was decreased effectively LMA group than ET group between pre-induction and 1 minute after intubation, between 1 minute after intubation and 2 minute after intubation (p<0.05). But, SI and CI were no difference between ET group and LMA group during induction of anesthesia and intubation (p<0.05).
CONCLUSION
The insertion of LMA is beneficial for certain patients than endotracheal tube to avoid harmful cardiovascular response in the management of airway during anesthesia.
- Comparison of Ventilations with LMA and Endotracheal Tube during Closed Circuit Anesthesia
- Il Woo Shin, Kyeong Eon Park, Hee Dong Chung, Ju Tae Sohn, Heon Keun Lee, Young Kyun Chung
- Korean J Crit Care Med. 2004;19(2):126-129.
- 3,365 View
- 39 Download
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Abstract
PDF
- BACKGROUND
LMA has larger dead-space than tracheal tube, ventilation may be influenced by difference of dead space. Closed circuit mechanical ventilation has high risk of hypercarbia because of inadequate CO2 elimination or gas supply. Thus, end-tidal carbon dioxide tension (EtCO2) and arterial carbon dioxide tension (PaCO2) were compared during closed circuit mechanical ventilation with LMA or tracheal tube. METHODS: Thirty adult patients scheduled for general anesthesia were divided into 2 groups. After induction of general anesthesia, laryngeal mask airway (Group 1, n=15) or tracheal tube (Group 2, n=15) were randomly inserted and closed circuit mechanical ventilation was initiated. When steady state had been reached, PaCO2 and EtCO2 were recorded. RESULTS: The PaCO2 was 32.2+/-2.8 (Group 1), 31.5+/-2.2 (Group 2) and the EtCO2 was 33.0+/-2.9, 31.6+/-2.4 respectively and there was no statistical significance between groups. The difference of arterial and end-tidal carbon dioxide tension in each group was -0.8+/-2.6, -0.03+/-2.2 respectively and there was no statistical significance between groups. CONCLUSIONS: The results indicate that in patients who are mechanically ventilated via the closed circuit system, EtCO2, PaCO2, and the difference between arterial and end-tidal carbon dioxide tension were not significantly different between groups.
Case Reports
- Use of Laryngeal Mask Airway Proseal for Stereotactic Biopsy of Brain Tumor in which Difficult Intubation was Expected under General Anesthesia: A Case Report
- Yun Hong Kim, Hyun Soo Kim, Sung Ha Mun, Hyun Seung Lee
- Korean J Crit Care Med. 2004;19(1):47-51.
- 1,605 View
- 13 Download
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Abstract
PDF
- Stereotactic surgery is a technique allowing the operation of an intracranial lesion without the need for craniotomy. Now stereotactic technique is widely used for aspiration of brain abscess or hemorrhage, biopsy of brain tumor and treatment of movement disorder etc. Because of the frame of stereotactic system, that is fixed on the scalp, laryngoscopic endotracheal intubation may be disturbed. So, in this case, we used laryngeal mask airway Proseal (PLMA(TM)) for maintenance of airway during stereotactic biopsy of brain tumor under general anesthesia. It was easily to insert PLMA(TM) using the introducer at once. The ventilation during the operation was not impeded at all time. There were not excessively changes of vital sign during general anesthesia. We think that PLMA(TM) may be a good alternative method for maintenance of airway during stereotactic surgery under general anesthesia.
- Use of Laryngeal Mask Airway ProsealTM in a Total Thyroidectomy for Huge Thyroid Tumor: A case report
- Hyun Soo Kim, Yun Hong Kim, Hyun Woo Nam
- Korean J Crit Care Med. 2002;17(1):38-41.
- 1,485 View
- 26 Download
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Abstract
PDF
- This is a case of anesthesia for a 49 year old woman with huge thyroid tumor who was admitted for total thyroidectomy. General anesthesia for thyroidectomy has traditionally involved tracheal intubation. But, we failed orotracheal intubation as in ability to insert a tracheal tube from the oropharynx into the trachea. After laryngoscopy was attempted three times, a laryngeal mask airway ProSealTM (PLMATM), size 3, was requested. The device was passed easily, and a patent airway was obtained. During general anesthesia, patient was mechanically ventilated through the PLMATM to airway pressures of approximately 20 cmH2O and positive pressure ventilation without air leaks was possible. Total thyroidectomy was performed without hypoxia and hypercarbia.
Original Articles
- Assessment of Positive Pressure Controlled Ventilation with the Laryngeal Mask Airway
- Young Soon Lim, Sang Kyi Lee
- Korean J Crit Care Med. 1999;14(2):148-153.
- 1,701 View
- 16 Download
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Abstract
PDF
- BACKGOUND: Cuff overinflation may cause premature rejection of the laryngeal mask airway (LMA) or provocation of incomplete and ineffective reflex responses. Therefore a previous report recommends that the cuff is inflated to a pressure of 60 cmH2O to minimize side effects. The objective of this study was to assess the possibility of controlled positive pressure ventilation in adults when intra-cuff pressure of LMA was set to 60 cmH2O.
METHODS
We studied 20 adult patients who received general inhalational anesthesia with LMA and mechanical positive pressure ventilation for gynecological operations. The following variables was determined during anesthesia at two time points 3 min after endotracheal intubation and 5 min before neuromuscular blockade: pop-off pressure, tidal volume, peak-air way pressure, plateau pressure, compliance, SpO2, and ETCO2.
RESULTS
Mean compliances measured were normal. Mean airway pressures (peak, plateau) were 13.6 and 15.1 cmH2O at two time points respectively while setting the tidal volume with 10 ml/kg. However, pop-off pressure were 18.3 and 20.1 cmH2O, respectively. Mean tidal volumes without gas leak around the LMA cuff were 14.5 and 14.5 ml/kg, respectively. Mean SpO2 and mean ETCO2 were measured 99.0 and 99.2%, 31.3 and 30.3 mmHg in two time points, respectively.
CONCLUSIONS
The study suggested that controlled mechanical positive pressure ventilation using the laryngeal mask airway with 60 cmH2O intra-cuff pressure were be adequate when pulmonary compliance and airway resistance were normal.
- Differences of Incidence and Severity of Sore Throat and Hoarseness between the Methods of Airway Security
- Yeoung Hwan Choi, Hee Chung Kim
- Korean J Crit Care Med. 1997;12(1):43-48.
- 1,563 View
- 19 Download
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Abstract
PDF
- Introduction: The sore throat and hoarseness are common complications during the postoperative period. We investigated differences of incidence and severity of sore throat and hoarseness according to methods of airway security.
METHODS
One hundred twelve patients, in ASA physical status class 1~2, were included in this study (58 males and 54 females). They were divided into three groups: group 1 (n=42), intubated with endotracheal tube lubricated with normal saline; group 2 (n=40), intubated with endotracheal tube lubricated with 5% lidocaine ointment; group 3 (n=30), inserted with laryngeal mask airway (LMA) for airway security.
RESULTS
The incidence of sore throat and hoarseness were 78.6% and 54.8% in group 1, 35% and 30% in group 2, and 33.3% and 20.0% in group 3.
CONCLUSIONS
Both 5% lidocaine-lubricated endotracheal tube and laryngeal mask airway showed tendency of decreased incidence of postoperative sore throat and hoarseness but there are no statistical significance.
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