Isoflurane alone versus small dose propofol with isoflurane for removal of laryngeal mask airway in children-a randomized controlled trial.

OBJECTIVE: To compare the safety of laryngeal mask airway removal using two different deep anaesthesia techniques in paediatric patients. METHODS: The Randomized Control Trial was conducted at Aga Khan University Hospital, Karachi, from April 2012 to November 2013, and comprised patients aged 2-10 years scheduled for infraumbilical surgeries. Anaesthesia was induced with sevoflurane and later it was maintained by is oflurane, oxygen and nitrous oxide. The laryngeal mask airway was removed in the intervention group-I at 0.4 minimum alveolar concentration of isoflurane with propofol 1mg/kg. In the control group-II, it was removed at 1.2 minimum alveolar concentration of isoflurane alone. SPSS 19 was used for data analysis. RESULTS: Of the 50 patients, there were 25(50%) in each of the two groups. Overall, there were 46(92%) males and 4(8%) females. Incidence of airway obstruction and teeth clenching was significantly higher in group-II (p<0.05 each). Emergence duration was also significantly increased in group-II compared to group-I (p=0.001). The Post-Anaesthesia Care Unit stay timing was not significantly different between the groups (p=0.74). CONCLUSIONS: Laryngeal mask airway removal under deep anaesthetic technique of low-dose propofol with isoflurane was found to be associated with minimal adverse airway events than isoflurane alone in paediatric patients.

A survey of undergraduate anesthesia rotation in medical colleges of Pakistan.

BACKGROUND: Student perceptions of specialties influence career choice decisions. It is important to expose undergraduates to the scope of rewarding careers in specialties like anesthesia by ensuring a good quality educational experience during anesthesia rotation. Our objective was to survey the curriculum structure and placement of the anesthesia undergraduate rotation in all the medical colleges of Pakistan recognized by the Pakistan Medical and Dental Council. MATERIALS AND METHODS: A standardized survey questionnaire was distributed by direct contact, postal mail or e mail to one identified anesthetist in all recognized medical colleges with enrolment of 100 or more students. The response rate was 75%. We received responses by hand, email and postal mail. RESULTS: We received responses from 15 out of 20 anesthetists contacted. 11 reported undergraduate anesthesia rotation while 4 reported absence of this rotation in their undergraduate curriculum. The rotation placement, duration and curriculum showed a wide variation and lack of standardization. CONCLUSION: Our survey indicates that the inclusion of anesthesia rotation in undergraduate medical education is not mandatory and standardized. The rotation duration, placement and curriculum need to be standardized to enhance the quality of the experience and promote the scope of the specialty for rewarding careers.