Search

Background: Supraglottic airways (SGA) are increasing used in pediatric anesthesia. Among SGA i-gelTM is commonly used device in pediatric patients. The BlockbusterTM laryngeal mask airway (LMA) is latest addition in pediatric airway armamentarium. This study was conducted to compare the clinical performance of i-gelTM and BlockbusterTM LMA in pediatric patients. Methods: A total of 140 children aged 1–5 years, who were undergoing elective surgery, were randomized into two groups either i-gelTM (Group I) or BlockbusterTM LMA (Group B). Airway was secured with appropriate-sized LMA according to group allocation under general anesthesia. The primary objective of study was oropharyngeal leak pressures (OPLP), and secondary objectives were number of attempts of device insertion, success rate, ease of LMA insertion, hemodynamic parameters, and postoperative pharyngolaryngeal morbidities. Results: The mean OPLP was significantly higher for i-gelTM compared to BlockbusterTM LMA (27.97 ± 1.65 vs. 26.04 ± 2.12; P < 0.000). The devices were successfully inserted on the first attempt in 97.14% and 90% of the i-gelTM group and BlockbusterTM LMA groups respectively. The insertion time, ease of insertion, hemodynamic parameters and postoperative complications were comparable between groups. Conclusions: The i-gelTM was more efficacious device in term of OPLP than BlockbusterTM LMA for positive pressure ventilation in pediatric patients undergoing short surgical procedures under general anesthesia.

Background: Epidural block placement in pediatric patients is technically challenging for anesthesiologists. The use of ultrasound (US) for the placement of an epidural catheter has shown promise. We compared landmark-guided and US-guided lumbar or lower thoracic epidural needle placement in pediatric patients.Methods: This prospective, randomized, comparative trial involved children aged 1–6 years who underwent abdominal and thoracic surgeries. Forty-five children were randomly divided into two groups using a computer-generated random number table, and group allocation was performed by the sealed opaque method into either landmark-guided (group LT) or real-time ultrasound-guided (group UT) epidural placement. The primary outcome was a comparison of the procedure time (excluding US probe preparation). Secondary outcomes were the number of attempts (re-insertion of the needle), bone contacts, needle redirection, skin-to-epidural distance using the US in both groups, success rate, and complications.Results: The median (interquartile range [IQR]) time to reach epidural space was 105.5 (297.0) seconds in group LT and 143.0 (150) seconds in group UT; P = 0.407). While the first attempt success rate was higher in the UT group (87.0% in UT vs. 40.9% in LT; P = 0.004), the number of bone contacts, needle redirections, and procedure-related complications were significantly lower. Conclusions: The use of US significantly reduced needle redirection, number of attempts, bone contact, and complications. There was no statistically significant difference in the time to access the epidural space between the US and landmark technique groups.