Comparative evaluation of Truview evo2 and Macintosh laryngoscope for ease of orotracheal intubation in children - A prospective randomized controlled trial.

BACKGROUND AND AIMS: Truview evo2 has been found to improve the glottic view when compared with the Miller blade in pediatric population. However, there is limited literature comparing it with Macintosh laryngoscope in children. We thus aimed to assess and compare Truview evo2 with the Macintosh laryngoscope for orotracheal intubation in children with regards to time to intubate, laryngoscopic view, ease of intubation, and associated hemodynamic changes. MATERIAL AND METHODS: Fifty ASA I-II children aged 2-8 years for elective surgery requiring general anesthesia with orotracheal intubation participated in this prospective randomized-controlled study. They were randomly allocated to two groups. In group-M (N = 25), laryngoscopy and intubation were performed using Macintosh laryngoscope, and in group-T (N = 25), Truview evo2 laryngoscope was used. Modified Cormack-Lehane grade, time to intubation, intubation difficulty score (IDS), and hemodynamic changes were compared between the groups. Data were analyzed using SPSS statistical software version 17 and P value <0.05 was considered statistically significant. RESULTS: CL grade 1 was found in a larger number of patients of group-T (P = 0.003) and CL grades2a and 2b were found in a larger number of patients of group-M (P = 0.023 and P = 0.037, respectively). The mean time to intubation was significantly longer in group-T (19.0 ± 3.4 seconds) than in group-M (13.1 ± 2.1 seconds), P = 0.00. The over all IDS was lower in group-T than group M [i.e. median (IQR): 0 (0-0) vs 1 (0-2), respectively]. Heart rate, systolic and diastolic blood pressure, and oxygen saturation were comparable between the groups at all times. CONCLUSION: Truview evo2 provides better laryngeal view and has a lesser IDS, but takes longer for intubation, when compared to the Macintosh laryngoscope in children.

Emergency Surgery in a Child with Cretinism with Anticipated Difficult Airway Under Low-Dose Subarachnoid Block.

A child with cretinism poses multiple anaesthetic challenges due to the associated mental and physical disability, deranged metabolic and physiologic functions, difficult airway and propensity to perioperative cardiorespiratory complications. Spinal anaesthesia in children is associated with remarkable cardiorespiratory stability and provides complete surgical anaesthesia. Here, we report a case that describes the first successful anaesthetic management of a child who was an unevaluated case of cretinism under subarachnoid block.

A prospective randomized double blind study to evaluate the effect of infusion of amino Acid enriched solution on recovery from neuromuscular blockade.

SUMMARY: Hypothermia is a common occurrence under anaesthesia and may prolong the duration of action of neuromuscular blockade. By limiting fall in temperature, an infusion of amino acid enriched solution may speed the recovery from neuromuscular blockade. We studied 60 ASA Grade - I/II patients of aged between 20 to 60 years scheduled for elective surgery under general anaesthesia. The patients were randomly divided into four groups to receive amino acid infusion with vecuronium bromide AV, normal saline with vecuronium bromide(CV), amino acid with atracurium besylate(A-At) and normal saline with atracurium besylate(C-At). Although there was a significantly lesser decrease in the core temperature from the baseline in all the patients receiving amino acid infusion (p<0.05), it significantly reduced the time to 25% recovery from the time of injection of vecuronium only. (60.59 +/- 11.39 in CV vs 51 +/- 14.72 min in AV) (P < 0.05), and not for atracurium.