Can positive-pressure ventilation be administered with laryngeal mask to pediatric patients undergoing laparoscopic inguinal hernia operation?

Abstract: Inguinodynia is persistence of pain for more than 3 months after inguinal hernia operation. Chronic pain may be associated with hyperesthesia or hypoesthesia. This pain may be mild, moderate or severe. Inguinodynia may even effect quality of life. Pain may resolve on its own or after conservative treatment. Sometimes it persists and conservative methods fail then various other modalities of treatment are considered including re-exploration and neurectomy. We performed all 396 inguinal hernia repair by a modified Lichtenstein tension-free procedure. In our series of 396 cases inguinodynia happened only in 3 cases, a real low incidence. Some researchers have reported the incidence of inguinodynia as high as 19 percent 1 year after operation. No case required re-exploration, removal of mesh or neurectomy in our series. Keywords Chronic pain, Inguinal hernia, Inguinodynia, inguinal hernia repair

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ProSeal versus Classic laryngeal mask airway (LMA) for positive pressure ventilation in adult patients undergoing elective surgery

10.1002/14651858.cd009026 ◽

2011 ◽

Cited By ~ 2

Author(s):

Muhammad Qamarul Hoda ◽

Khalid Samad ◽

Hameed Ullah

Keyword(s):

Laryngeal Mask Airway ◽

Positive Pressure Ventilation ◽

Elective Surgery ◽

Adult Patients ◽

Laryngeal Mask ◽

Positive Pressure ◽

Classic Laryngeal Mask Airway

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Abstract 59: The Incidence Of Pulmonary Aspiration With Laryngeal Mask Airway Use During Cardiopulmonary Resuscitation And Positive Pressure Ventilation In Swine.

Circulation ◽

10.1161/circ.116.suppl_16.ii_935-c ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Brian Suffoletto ◽

James Menegazzi ◽

Eric Logue ◽

David Salcido

Keyword(s):

Laryngeal Mask Airway ◽

Cardiopulmonary Resuscitation ◽

Positive Pressure Ventilation ◽

Validation Cohort ◽

Pulmonary Aspiration ◽

Laryngeal Mask ◽

Positive Pressure ◽

Suction Catheter ◽

Chest Compressions ◽

Lung Expansion

Objective: Pulmonary aspiration of gastric contents occurs 20 –30% of the time during cardiopulmonary resuscitation (CPR) of cardiac arrest. This is due to loss of protective airway reflexes, pressure changes generated during CPR, and positive pressure ventilation (PPV). Even though the American Heart Association (AHA) has recommended the laryngeal mask airway (LMA) as an acceptable alternative airway for use by EMS personnel, concerns over the capacity of the device to protect from pulmonary aspiration remain. We sought to determine the incidence of aspiration after LMA placement, CPR and PPV. Methods: We conducted a prospective study on 16 consecutive post-experimental mixed-breed domestic swine of either sex (mean mass 25.7 ±1.4 kgs). A standard size-4 LMA was modified so that a vacuum catheter could be advanced into and past the LMA diaphragm. The LMA was placed into the hypopharynx and its position confirmed using End-tidal CO 2 and direct visualization of lung expansion. Fifteen milliliters of heparinized blood were instilled into the pharynx. After 5 PPVs with a mechanical ventilator, chest compressions were performed for 60s with asynchronous ventilations continuing at a rate of 12 per minute. After chest compressions, a suction catheter was inserted through the cuff and suction applied for approximately 1 minute. The catheter was removed and inspected for signs of blood. The LMA cuff was deflated and the LMA removed. The intima of the LMA diaphragm was inspected for signs of blood. In a validation cohort of 4 animals, the LMA was reinserted, a cricothyrotomy performed and 5 mL of blood instilled directly into the trachea. Results: There were 0/16 (95% CI=0 –17%) with a positive tests for the presence of blood in both the vacuum catheter and the intima of the LMA diaphragm. In the validation cohort, all four were positive for blood in both the vacuum catheter and the intima of the LMA diaphragm. Conclusions: In this simple model of regurgitation of after LMA placement, there was no sign of pulmonary aspiration, and no evidence that blood had passed beyond the seal created by the LMA cuff. Concerns over aspiration with LMA use may be unfounded. Future studies should determine the frequency of pulmonary aspiration after LMA placement in the clinical setting.

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