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Biomedical subjects

J Brimacombe

Publications and source records attributed to J Brimacombe.

At least 19 recordsLinked to original sources
PubMed1995

A new laryngeal mask prototype. Preliminary evaluation of seal pressures and glottic isolation.

A new prototype laryngeal mask airway is described which incorporates a second mask to isolate the upper oesophagus and a second dorsal cuff to increase the seal against the glottis. We have made a within-patient comparison of seal pressures between the prototype and standard laryngeal mask airway in 20 patients, and determined if the prototype facilitates functional isolation of the glottis and upper oesophagus. Leak pressure was found to be significantly higher for the prototype and equalled or exceeded 5.0 kPa in all patients (p < 0.001). The prototype laryngeal mask airway provided functional isolation in all patients as judged by leak and placement of a gastric tube via the oesophageal mask. Ease of insertion and incidence of pharyngeal morbidity appeared similar to the standard laryngeal mask, but were not formally tested. The prototype laryngeal mask airway exhibits potentially useful new features which justify further evaluation and development.

Adult↗
PubMed1995

The laryngeal mask airway for dental surgery--a review.

The ideal airway requirements for oral surgery are the provision of a stable, unobstructed airway, protection of the lungs from aspiration, minimal interference with the surgical field and a low complication rate. Neither the nasal mask nor endotracheal tube meet these requirements. The laryngeal mask airway (LMA), provides a third type of airway for consideration in oral surgery that offers some of the benefits of intubation and avoids many of the associated hazards. It can be inserted without use of a laryngoscope or muscle relaxants, and is designed to produce an airtight seal around the laryngeal inlet. It provides a secure airway suitable for spontaneous or controlled ventilation and acts as an airtight throat pack. Scavenging of waste gases is possible, and it is well tolerated during recovery. A modification, specifically designed for head, neck and dental anaesthesia, has recently become available. The purpose of this article is to provide a brief overview of the LMA with special emphasis on its use in oral surgery.

Anesthesia, Dental↗
PubMed1995

Anaesthesia for laser pharyngoplasty--a comparison of the tracheal tube with the reinforced laryngeal mask airway.

A common cause of snoring is palatal flutter which occurs when turbulent air flow causes the flexible soft palate to flutter. Surgical correction involves either removal of the soft palate or a reduction in its flexibility. Laser pharyngoplasty is a new surgical procedure designed to stiffen the soft palate. It presents a unique combination of problems for the anaesthetist. In this paper we describe the evolution of the anaesthetic technique for laser pharyngoplasty and analyse the results of the first 165 cases. Points of particular interest include the use of the reinforced laryngeal mask airway compared with the tracheal tube and late onset pain.

Adult↗
PubMed1995

Measurement of neuromuscular blockade--a comparison between a new "homemade" force displacement transducer and the accelerometer.

Train-of-four (TOF) ratios are compared between a new homemade force pressure transducer and a commercially available accelerometer. Twenty adult patients were studied and 600 simultaneous TOF ratio pairs were recorded during anaesthesia with varying degrees of muscle relaxation. Laboratory testing revealed that the output from the homemade device was linear up to 900 g and that there was a linear relationship between the output from the new device and the accelerometer (y = 0.802x + 5.167, R = 0.943, t = 69, P < 0.0001). Although the homemade device underestimates the accelerometer TOF ratio by 20%, it is a reliable and economic alternative to commercially available products for measuring TOF ratios.

Acceleration↗
PubMed1995

The laryngeal mask airway for awake diagnostic bronchoscopy. A retrospective study of 200 consecutive patients.

The laryngeal mask airway (LMA) provides a view of the larynx and moving vocal cords without loss of airway control and can be used in flexible fibreoptic bronchoscopy for both anaesthetized and awake patients. In this retrospective review of 200 consecutive patients over a 30 month period, bronchoscopy was successful via the LMA in all but one patient using a technique of topical anaesthesia and sedation. The LMA directs the fibrescope to the glottis, allows respiratory function to be monitored and oxygen to be given. Complication rates were similar to those reported for transnasal awake bronchoscopy. Insertion of the LMA in the awake fasted patient is safe and easily achieved.

Adjuvants, Anesthesia↗