Please use this identifier to cite or link to this item: https://scholarbank.nus.edu.sg/handle/10635/209044
Title: Comparison between use of neuromuscular blocking agent and placebo with the intubating laryngeal mask airway.
Authors: Ambulkar, R
Tan, AYH 
Chia, NCH
Low, TC
Keywords: Adult
Androstanols
Double-Blind Method
Female
Humans
Intubation, Intratracheal
Laryngeal Masks
Male
Neuromuscular Blocking Agents
Rocuronium
Issue Date: Jun-2008
Publisher: SINGAPORE MEDICAL ASSOC
Citation: Ambulkar, R, Tan, AYH, Chia, NCH, Low, TC (2008-06). Comparison between use of neuromuscular blocking agent and placebo with the intubating laryngeal mask airway.. SINGAPORE MEDICAL JOURNAL 49 (6) : 462-465. ScholarBank@NUS Repository.
Abstract: INTRODUCTION: The intubating laryngeal mask airway (ILMA) is a specially-designed airway device that can be used for endotracheal intubation without direct laryngoscopy. The advantage of this device is that it allows blind endotracheal intubation with a predictably high success rate. The use of neuromuscular blocking agents in facilitating the use of the ILMA has been investigated in the Western population with a quoted successful intubation rate of 88-96 percent. This randomised, double-blind study aimed to see if the use of neuromuscular blocking agent is necessary for successful intubations. METHODS: A total of 150 patients, rated categories 1 and 2 on the American Society of Anesthesiology Physical Status Classification System, were induced with propofol 2.5 mg/kg and fentanyl 2 microg/kg. After insertion of the ILMA, the patients received either saline or 0.6 mg/kg of rocuronium. After 90 seconds, tracheal intubation was attempted using the specially-designed silicon endotracheal tube. In addition to the success rate of intubation, the incidence of complications was also recorded. RESULTS: The success rate for tracheal intubation within three attempts was 93.3 percent for the saline group and 92.0 percent for the rocuronium group; this was statistically insignificant. The time to securing the airway was 11.5 seconds for the saline group, compared to 10.0 seconds in the rocuronium group, but this was statistically insignificant. The incidence of coughing during insertion of the endotracheal tube was 42.7 percent in the saline group as compared to 1.3 percent in the rocuronium group (p-value is less than 0.001). 12 percent of the patients in the saline group moved during intubation, while none was reported to move in the rocuronium group (p-value is 0.003). These results compared favourably with rates quoted in studies conducted on Western populations. CONCLUSION: The intubating laryngeal mask airway-assisted intubation yields a high success rate, which was similar between the paralysed and non-paralysed patients, with no statistical significance. However, the non-paralysed patients were prone to coughing and movements during intubation, requiring supplemental propofol. © Singapore Medical Association
Source Title: SINGAPORE MEDICAL JOURNAL
URI: https://scholarbank.nus.edu.sg/handle/10635/209044
ISSN: 00375675
Appears in Collections:Staff Publications
Elements

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
4906a4.pdf193.95 kBAdobe PDF

CLOSED

None

Page view(s)

102
checked on Feb 2, 2023

Download(s)

3
checked on Feb 2, 2023

Google ScholarTM

Check


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.