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...

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Main Authors: Sushma K SannaBoraiah, HS Pushpavathi, KL Yashaswini
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2021-10-01
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
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author Sushma K SannaBoraiah
HS Pushpavathi
KL Yashaswini
author_facet Sushma K SannaBoraiah
HS Pushpavathi
KL Yashaswini
author_sort Sushma K SannaBoraiah
collection DOAJ
description 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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spelling doaj.art-322b5d4707db4b1e808febb017f59ee62022-12-21T17:44:38ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-10-011510UC05UC0910.7860/JCDR/2021/49381.15453Effect of Nebulised Lignocaine on the Quality of I-gel Insertion: A Randomised Controlled TrialSushma K SannaBoraiah0HS Pushpavathi1KL Yashaswini2Associate Professor, Department of Anaesthesia, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.Assistant Professor, Department of Anaesthesia, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.Student, Department of Anaesthesia, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.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.https://jcdr.net/articles/PDF/15453/49381_CE[Ra1]_F[SH]_PF1(PS_SHU)_PN(KM).pdfairway managementhaemodynamic responsegeneral anaesthesiasupraglottic airway devices
spellingShingle Sushma K SannaBoraiah
HS Pushpavathi
KL Yashaswini
Effect of Nebulised Lignocaine on the Quality of I-gel Insertion: A Randomised Controlled Trial
Journal of Clinical and Diagnostic Research
airway management
haemodynamic response
general anaesthesia
supraglottic airway devices
title Effect of Nebulised Lignocaine on the Quality of I-gel Insertion: A Randomised Controlled Trial
title_full Effect of Nebulised Lignocaine on the Quality of I-gel Insertion: A Randomised Controlled Trial
title_fullStr Effect of Nebulised Lignocaine on the Quality of I-gel Insertion: A Randomised Controlled Trial
title_full_unstemmed Effect of Nebulised Lignocaine on the Quality of I-gel Insertion: A Randomised Controlled Trial
title_short Effect of Nebulised Lignocaine on the Quality of I-gel Insertion: A Randomised Controlled Trial
title_sort effect of nebulised lignocaine on the quality of i gel insertion a randomised controlled trial
topic airway management
haemodynamic response
general anaesthesia
supraglottic airway devices
url https://jcdr.net/articles/PDF/15453/49381_CE[Ra1]_F[SH]_PF1(PS_SHU)_PN(KM).pdf
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