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657: Safety of Sevoflurane Sedation for Peribulbar Anaesthesia
Posters
568. The lma ctrach™ in morbidly obese and lean patients undergoing gynaecological procedures: a comparative study T. Sahin Yildiz, D. Ozdamar, I. Arslan, M. Solak, K. Toser Kocaeli University, Anesthesiology, Kocaeli, Turkey Background and Aims: The LMA CTRACH™ (CT) is a new ventilatory and intubating device which demonstrated beneficial airway management performance in difficult airway patients. We tested the hypothesis that the CT is efficient for tracheal intubation of morbidly obese patients who are at risk of a difficult airway. Methods: After Ethics’ Committee approval, 60 adult patients (30 morbidly obese patients with body mass index ⬎ 40 kg/m2 and 30 lean patients with body mass index ⬍ 30 kg/m2) scheduled to undergo gynaecologic surgery were enrolled in this prospective study. Induction of anesthesia was standardized using propofol, fentanil and rocuronium. Insertion and intubation success rates, time taken to achieve intubation, airway complications and haemodynamic parameters were recorded. Results: The CT was successfully inserted and adequate ventilation through the CT was achieved in 59 patients (98.33%). Only in one patient in the nonobese group was not able to ventilation through the CT. We were successfull in endotracheal intubation, either under vision or blind, in 56 patients (93.33%). We were able to view the larynx in 51 patients (85%). Total intubation time was significantly longer in morbidly obese patients (96 s, SD 73.8) than in lean patients (45 s, SD 29.6) (p⬍ 0.05). Conclusions: We demonstrated that the CT was an efficient airway device for ventilation and tracheal intubation in case of a difficult airway in morbidly obese gynaecologic patients.
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Miscellaneous
259
657. Safety of sevoflurane sedation for peribulbar anaesthesia J. Soliveres1, J. Blaguer2, C. Solaz2, M. Estruch2, J. Sanchez2 1Hospital Universitario Dr Peset, Aanesthesia, Valencia, Spain, 2Hospital Universitario Dr Peset, Valencia, Spain Background and Aims: Peribulbaranaesthesia injection pain is still a challenge. Wether propofol sedation is agood choice, sevoflurane deep sedation may be a valid alternative. Ourobjective is to evaluate safety of sevoflurane deep sedation during peribulbarinjection. Methods: Alter localethics committe approval, written informed consent was obtained from 70consecutive ASA I-III patients scheduled for cataract surgery. After a iv lineplaced, non invasive blood pressure, 3 lead ECG and pulseoximetry weremonitored. 8% sevoflurane was delivered via face mask from a 8 Lmin⫺1fresh flow gas circular circuit machine (Datex Aspire). When patient fellasleep (unarousable), a gently neck extension was carried out and a standardperibulbar anesthesia with 1% plain ropivacaine (8-10mL) with hyaluronidase (15UImL⫺1)was performed. The patient was manually ventilated if necessary. If head orhands movements were observed, the patient was gently secured. If the patientwas presumed to sneeze, the needle was quickly withdrawn and the puncturestarted again. All patients were observed until awakening. Basal andpost-peribulbar anesthesia BP, HR and maximum desaturation were evaluated bypaired samples t-test or Wilcoxon test. A p⬍ 0,05 was considered significant. Results: 64 patientswere included. 2 were excluded because of fear to anaesthesia, one due to monitorfailure and four for data loss. Mean age was 64 yr (SD⫽12,6). ASA II/III: 49/15.The procedure could be performed in all patients. Two patients sneezed. Onepatient complained about the face mask. Three patients complained aboutshivering during surgery. None required ventilation. Nine patients had head orhands movement. Time to sleep was 93,2(39,6) seconds. BP and HR fell within 25%from baseline. Baseline Post-anaesthesia SBP(*) 148,3(24,6) 124,1(20,8) MBP(*) 105,4(19,9) 93,2(15,2) DBP(*) 78,6(12,6) 69,1(10,8) HR(*) 77,4(14,5) 71,3(15,1) SpO&rtf-inf-start;2&rtf-inf-end; 99(97-99) 100(99-100) Data showmean(SD) or median(percentil 75)(*)p⬍ 0,05. Conclusions: Sevoflurane sedation is safe for peribulbar anaesthesia.
568. The lma ctrach™ in morbidly obese and lean patients undergoing gynaecological procedures: a comparative study T. Sahin Yildiz, D. Ozdamar, I. Arslan, M. Solak, K. Toser Kocaeli University, Anesthesiology, Kocaeli, Turkey Background and Aims: The LMA CTRACH™ (CT) is a new ventilatory and intubating device which demonstrated beneficial airway management performance in difficult airway patients. We tested the hypothesis that the CT is efficient for tracheal intubation of morbidly obese patients who are at risk of a difficult airway. Methods: After Ethics’ Committee approval, 60 adult patients (30 morbidly obese patients with body mass index ⬎ 40 kg/m2 and 30 lean patients with body mass index ⬍ 30 kg/m2) scheduled to undergo gynaecologic surgery were enrolled in this prospective study. Induction of anesthesia was standardized using propofol, fentanil and rocuronium. Insertion and intubation success rates, time taken to achieve intubation, airway complications and haemodynamic parameters were recorded. Results: The CT was successfully inserted and adequate ventilation through the CT was achieved in 59 patients (98.33%). Only in one patient in the nonobese group was not able to ventilation through the CT. We were successfull in endotracheal intubation, either under vision or blind, in 56 patients (93.33%). We were able to view the larynx in 51 patients (85%). Total intubation time was significantly longer in morbidly obese patients (96 s, SD 73.8) than in lean patients (45 s, SD 29.6) (p⬍ 0.05). Conclusions: We demonstrated that the CT was an efficient airway device for ventilation and tracheal intubation in case of a difficult airway in morbidly obese gynaecologic patients.
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Miscellaneous
259
657. Safety of sevoflurane sedation for peribulbar anaesthesia J. Soliveres1, J. Blaguer2, C. Solaz2, M. Estruch2, J. Sanchez2 1Hospital Universitario Dr Peset, Aanesthesia, Valencia, Spain, 2Hospital Universitario Dr Peset, Valencia, Spain Background and Aims: Peribulbaranaesthesia injection pain is still a challenge. Wether propofol sedation is agood choice, sevoflurane deep sedation may be a valid alternative. Ourobjective is to evaluate safety of sevoflurane deep sedation during peribulbarinjection. Methods: Alter localethics committe approval, written informed consent was obtained from 70consecutive ASA I-III patients scheduled for cataract surgery. After a iv lineplaced, non invasive blood pressure, 3 lead ECG and pulseoximetry weremonitored. 8% sevoflurane was delivered via face mask from a 8 Lmin⫺1fresh flow gas circular circuit machine (Datex Aspire). When patient fellasleep (unarousable), a gently neck extension was carried out and a standardperibulbar anesthesia with 1% plain ropivacaine (8-10mL) with hyaluronidase (15UImL⫺1)was performed. The patient was manually ventilated if necessary. If head orhands movements were observed, the patient was gently secured. If the patientwas presumed to sneeze, the needle was quickly withdrawn and the puncturestarted again. All patients were observed until awakening. Basal andpost-peribulbar anesthesia BP, HR and maximum desaturation were evaluated bypaired samples t-test or Wilcoxon test. A p⬍ 0,05 was considered significant. Results: 64 patientswere included. 2 were excluded because of fear to anaesthesia, one due to monitorfailure and four for data loss. Mean age was 64 yr (SD⫽12,6). ASA II/III: 49/15.The procedure could be performed in all patients. Two patients sneezed. Onepatient complained about the face mask. Three patients complained aboutshivering during surgery. None required ventilation. Nine patients had head orhands movement. Time to sleep was 93,2(39,6) seconds. BP and HR fell within 25%from baseline. Baseline Post-anaesthesia SBP(*) 148,3(24,6) 124,1(20,8) MBP(*) 105,4(19,9) 93,2(15,2) DBP(*) 78,6(12,6) 69,1(10,8) HR(*) 77,4(14,5) 71,3(15,1) SpO&rtf-inf-start;2&rtf-inf-end; 99(97-99) 100(99-100) Data showmean(SD) or median(percentil 75)(*)p⬍ 0,05. Conclusions: Sevoflurane sedation is safe for peribulbar anaesthesia.