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Mask Insertion (mask + insertion)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Infusion requirements and reversibility of rocuronium at the corrugator supercilii and adductor pollicis muscles

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 10 2009
T. SUZUKI
Background: The aim of this study is to compare the infusion rates required to maintain a constant neuromuscular block and the reversibility of rocuronium at the corrugator supercilii muscle (CSM) and the adductor pollicis muscle (APM). Methods: We randomly allocated 30 female patients into two groups of 15 patients each to monitor neuromuscular block at either the CSM or the APM. After induction of anaesthesia and laryngeal mask insertion, contraction of the CSM to the facial nerve stimulation or that of the APM to the ulnar nerve stimulation was quantified using an acceleromyograph during 1.0,1.5% end-tidal sevoflurane anaesthesia. All the patients received a bolus of 1 mg/kg rocuronium. When the first twitch (T1) of train-of-four (TOF) recovered to 10% of the control, rocuronium infusion was commenced and maintained at T1 of 10% of the control at the CSM or APM for 120 min. Immediately after rocuronium infusion was discontinued, the time required for 0.04 mg/kg neostigmine-facilitated recovery to a TOF ratio of 0.9 was recorded. Results: Rocuronium infusion dose after a lapse of 120 min was significantly larger in the CSM than in the APM [7.1 (2.3) vs. 4.7 (2.6) ,g/kg/min; P=0.001]. The time for facilitated recovery was shorter in the CSM than in the APM [11.4 (3.8) vs. 16.2 (6.0) min; P=0.016]. Conclusion: A larger rocuronium infusion dose was required to maintain a constant neuromuscular block at the CSM. Neostigmine-mediated reversal was faster at the CSM. [source]

Effect-site concentration of remifentanil for laryngeal mask airway insertion during target-controlled infusion of propofol

ANAESTHESIA, Issue 2 2009
M. K. Kim
Summary The purpose of this study was to determine the effect-site concentration of remifentanil that would provide optimal conditions for successful laryngeal mask airway insertion during a target-controlled infusion (TCI) of propofol at 3.5 ,g.ml,1 without the use of neuromuscular blockade. Five minutes after propofol infusion, remifentanil was infused at a dose determined by a modified Dixon's up-and-down method. Five minutes after remifentanil infusion, the laryngeal mask was inserted. The effect-site concentration of remifentanil for successful laryngeal mask insertion in 50% of adults (EC50) was 3.04 (SD 0.49) ng.ml,1 during a TCI of 3.5 ,g.ml,1 propofol without neuromuscular blockade. From the probit analysis, the EC50 and EC95 of remifentanil were 2.84 ng.ml,1 (95% CI 2.09,3.57 ng.ml,1) and 3.79 ng.ml,1 (95% CI 3.26,9.25 ng.ml,1), respectively. [source]

Facilitation of laryngeal mask airway insertion,Effects of remifentanil administered before induction with target-controlled propofol infusion

ANAESTHESIA, Issue 9 2001
K. Grewal
Eighty-six adult day-case patients were recruited into a prospective, randomised study and allocated to one of two groups. Patients received either intravenous remifentanil 0.3 µg.kg,1 or an equivalent volume of sodium chloride 0.9% followed by induction of anaesthesia with propofol target-controlled infusion until the effect (brain) site calculated concentration was 2 µg.ml,1. Jaw opening and ease of laryngeal mask insertion were assessed immediately after mask insertion. A higher incidence of failure of induction of anaesthesia was observed in the control group compared with the remifentanil group [15 (35%) vs. 3 (7%); p < 0.01] and addition of remifentanil significantly increased the ease and success of laryngeal mask insertion, with grade 1 (no coughing/gagging) conditions observed in 29 (68%) of the remifentanil group and 21 (49%) of the control group (p < 0.01). The doses of remifentanil and propofol used were not associated with any significant cardiorespiratory instability. In conclusion, when combined with propofol target-controlled infusion, remifentanil 0.3 µg.kg,1 facilitates laryngeal mask insertion with minimal adverse haemodynamic changes. [source]