الفهرس 
INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
This study was carried out in EI-M inia University hospital on 40 patients
both sex in order to evaluate both the LMA and the COlllbitube as an airway anagement devices as regard adequate ventilation, oxygenation, pressor sponse and complications. In spontaneously breathing patients scheduled for a ariety of elective surgical procedure expected to be less than 2 hours and not
,
’equiring muscle relaxation. The patients were allocated to two groups. The
lirway of the first group was managed by the LMA while that of the second was managed by the Combitube. The patients are preoxygenated with 100% 02 for 3 minutes. Then induction of anaesthesia in all patients of the two groups was ~one by 1.5 p g/kg fentanyl and 1-2 mg/kg propofo1. Until .raw relaxation was obtained, then the patients were instrumented either by the LMA or ·by Cornbitube. Both devices were inserted blindly into the mouth according to the manufacturer’s instruction, inf1atioll of the cufT of the LMA by the recommended volume of air. Inflation of the oropharyngeal balloon of the Combitube by 85 1111 of air and esoph<lgeal cull’ by 5-12 ml of air.
Verification of proper positioning of the LMA and the Combitube was done by auscultation of adequate air entry on the chest.
Anesthesia W8S maintained with halothane 1-2% in nitrous oxide: oxygen the patients 8110wed to breath spontaneously through Bain circuit at the end of the operation~ anesthesia was interrupted and patients breathed 100% oxygen until return of airway reflexes then the cuffs were deflated and the devices was removed.
The parameters which were assessed include: arterial oxygen saturation, end tidal carbon dioxide tension, systolic B.P, diastolic B.P, mean B.P and heart rate. All p;:lrameters except ETC02 tensioll, were recorded before induction,
er induction, after insertion of the device, 5 minutes, 10 minutes, 15 minutes 00 30 minutes after insertion of the device. The ETC02 values were recorded er insertion, 5 minutes, 10 minutes, 15 minutes and 30 minutes after insertion the device. Patients were visited 6 hours after the operettion to determine the idence of postoperative sore throat,. hoarseness of voice, or dysphagia. There
as no significant difference between the two devices in arterial oxygen mluration and end-tidal carbon dioxide tension.
This means that both the LMA and the Combitube provide adequate ventilation and oxygenation for the patients. Both of the laryngeal mask airway and the cOlllbitube are feasible airway management device. I nsettion of the LMA was not associated with cardiovascular response, so its use may be recommended for patients in whom a marked pressor response would be deterious, while insertion of the Combitube was associated with significant cardio-vascular response which represent (I serious Iwzard to pat ients with cardiovascular or cerebro vascular disease, e.g aortic dissection or subarachnoid bleeding.
Incidence of post-operative complications such as dysphagia, sore throat and upper airway trauma was higher in the Combitube group than LMA group. These complications most probably due to high pressure in the oropharyngeal balloon which is filled with 85 m L of (lir according to the instruction mClnual of the Combitube.
Both laryngeal mask allway and combitube are p8tent aIrway management device providing adequate ventilation and oxygenation for patients. One of the advantage of the Combitube in comparison with the LMA is that it is designed to 8110w regurgitated gastric contents to be delivered a way from the airway as well as to be suctioned so,it is recommenclecl for di fficult intubation