PubMed · 2237018
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M T Bernabé-Garrido. [Electronic gas analyzer].. https://pubmed.ncbi.nlm.nih.gov/2237018/
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BACKGROUND: The laryngeal mask airway (LMA) causes fewer haemodynamic changes, particularly in mean arterial pressure (MAP) and heart rate (HR), than tracheal intubation using either laryngoscopy or the intubating LMA. There are no data for patients with coronary artery disease. METHOD: We studied 27 patients having coronary artery bypass grafting, prospectively randomized to be managed with either the LMA or tracheal intubation using either laryngoscopy or the ILMA. We used invasive monitoring to compare the haemodynamic effects in each group during induction and emergence from anaesthesia. RESULTS: Both methods of intubation caused an increase in MAP compared with the LMA (P<0.05). Mixed venous oxygen saturation increased in the intubated patients but not with the LMA (P<0.05). HR did not change at induction in the LMA group. Changes at extubation were similar in all groups but cardiac index was lower in the LMA group (P<0.05). CONCLUSION: The LMA allows airway management without hypertension and tachycardia and should be considered when anaesthetizing patients with coronary disease.
BACKGROUND: The modified nasal trumpet (MNT) is a prepackaged nasopharyngeal airway modified with distal holes and fitted with a 15 mm adaptor allowing connection to an anaesthesia circuit. It may be useful for airway management during anaesthesia. METHODS: After applying a spray to constrict the nasal mucosa, we used the MNT in 346 spontaneously breathing patients for three indications: alone as an airway device during general anaesthesia, to provide supplemental oxygen immediately after extubation instead of by facemask, and to facilitate fibreoptic intubation during general anaesthesia. RESULTS: The device was successful for giving supplemental oxygen after extubation (n=244) and facilitating fibreoptic intubation (n=28). When used as an airway for general anaesthesia, it was only successful without manipulation in 33 of 74 patients (45%). The MNT was easy to insert in awake patients. We encountered six complications: one MNT folded in the pharynx, and five patients (1.4%) experienced nosebleeds. CONCLUSIONS: The MNT was disappointing as a primary airway device under general anaesthesia but was useful for giving oxygen after extubation and for facilitation of fibreoptic intubation. It can cause nosebleeds.