Effect of Nebulised Lignocaine on the Quality of I-gel Insertion: A Randomised Controlled Trial
Introduction: Supraglottic Airway Devices (SAD) are integral part of airway management during General Anaesthesia (GA) and are less invasive than endotracheal intubation. I-gel is a novel and innovative SAD, with non inflating cuff and it is widely used among available devices. Various drug comb...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-10-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/15453/49381_CE[Ra1]_F[SH]_PF1(PS_SHU)_PN(KM).pdf |
| Summary: | Introduction: Supraglottic Airway Devices (SAD) are integral
part of airway management during General Anaesthesia (GA)
and are less invasive than endotracheal intubation. I-gel is a
novel and innovative SAD, with non inflating cuff and it is widely
used among available devices. Various drug combinations are
being studied to obtain better insertion conditions. Lignocaine
nebulisation is popularly used as topical anaesthesia for the
airway. Authors hypothesised that it could improve the insertion
conditions of the airway in addition to induction agents.
Aim: To assess the efficacy of lignocaine nebulisation for I-gel
insertion conditions in terms of the frequency of optimal insertion
conditions and haemodynamic changes observed during and
after the insertion of I-gel.
Materials and Methods: This randomised controlled trial was
conducted for one year from January 2019 to January 2020
in Karnataka Institute of Medical sciences, Hubli, Karnataka,
India. Ninety patients of age group 18 to 45 years, belonging
to American Society of Anaesthesiologists' (ASA) grade I and
II, undergoing minor surgical procedures were included. They
were randomised into two equal groups, group L received 5
mL of 4% lignocaine and group D received 5 mL of normal
saline nebulisation 5 minutes before induction of GA. Optimal
insertion conditions (successful insertion at the first attempt
without adverse response) and haemodynamic responses were
noted down as primary and secondary outcomes respectively.
The data was analysed using Chi-square test and Student's
t-test according to parameters.
Results: A total of 43 patients were in group lignocaine
nebulisation (Group L) and 44 in the normal saline nebulisation
group (Group D) and they had the mean age of 28.8±6.3 and
29.0±5.1 respectively. The optimal insertion (p-value 0.26),
successful first attempt insertion (p-value 0.175) and time
for insertion (p-value 0.512) were not statistically significant
between the two groups. In group L at 1 and 5 minutes, fall
in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure
(DBP) was noted and compared with other group which was not
statistically significant.
Conclusion: Preinduction lignocaine nebulisation doesn't
improve optimal insertion conditions of I-gel statistically. Even
though better haemodynamic were noted with the same, it cannot
be recommended for the sole purpose by nebulisation route. |
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| ISSN: | 2249-782X 0973-709X |