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ANESTHESIA QUICK REVISION NOTES

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INSTRUMENTS IN ANESTHESIA : LMA (Laryngeal mask airway ) / SAD (Supraglottic airway device ) Scientist who invented it - Archie Brain Types of LMAs : ( Active recall – try to identify and recall important points about each of these ) First generation LMA •• Example – LMA classicQ •• Important features - single tube present (airway tube ), which can be used for ventilation only - Demerit : cannot prevent aspiration Second generation LMA •• Examples - LMA supreme, Proseal LMA, I gel LMA, Fast trach LMA or Intubating LMA •• Important features - They have airway tube and gastric tube •• They create a better seal with the larynx than first generation LMAs •• They are safer and protects better against aspiration 84 Cerebellum Quick Revision Notes LMA CLASSIC •• First generation LMA •• Important features - single tube present (airway tube ) •• Demerit : cannot prevent aspiration LMA supreme •• Second generation LMAQ •• Disposable Fast track LMA or Intubating LMA •• Made up of Silicone •• Non disposable •• Can be used upto 40 times •• Pilot Balloon is present •• It has a special endotracheal tube used for intubating ‘through’ the LMA •• It is sterilized by Autoclaving PROSEAL LMA •• It is made up of Silicone •• It is reusable / non disposable •• Pilot balloon is present •• It forms a good seal with the larynx preventing aspiration of gastric contents. Hence, it is called as ‘Proseal’ It is the LMA preferred for Day care Surgery / Laproscopic Surgery I - gel LMA •• Main identification feature – It does not have a pilot balloon •• It is made up of Thermoelastic polymer Recommended size of the laryngeal mask airway according to the patient's body weightQ. Size Patient's weight 1 5 kg 1.5 5-9 kg 2 10-19 kg 2.5 20-29 kg 3 30-49 kg 4 50-69 kg 5 Large adult, 70-100 kg Ideal patient position preferred for intubation : Sniffing the morning air position / barking dog position Q 85 Anesthesia Extension of atlanto occipital joint Flexion of cervical spine Flexion at Atlantoaxial joint and extension at Atlantooccipital joint Steps of Intubation 1. Insert the Laryngoscope in the right corner of the mouth 2. Sweep the tongue from right to leftQ 3. Then lift the laryngoscope 4. Once the vocal cords are seen pass the endotracheal tube 5. Inflate the cuff of the endotracheal tube and connect the anesthesia circuit 6. Confirm intubation by capnography (gold standard) or by auscultation or chest XrayQ Identification of types of laryngoscope: (Active recall) MacIntosh laryngoscope •• It has a Curved blade •• It is used in Adults McCoy laryngoscopeQ •• It has a curved blade with a lever which helps in lifting the epiglottis •• It is used for difficult intubation Millers laryngoscope •• It has a straight blade •• It is used in pediatric patients

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ANESTHESIA QUICK REVISION NOTES




MKT ( MUST KNOW TOPICS) : INSTRUMENTS IN ANESTHESIA :
Drugs and Instruments in Pre-Anesthesia Evaluation LMA (Laryngeal mask airway ) / SAD (Supraglottic
Anesthesia airway device )
Monitoring in Anesthesia Cardiopulmonary Scientist who invented it - Archie Brain
resuscitation
Types of LMAs : ( Active recall – try to identify and
recall important points about each of these )




First generation LMA LMA, Fast trach LMA or Intubating LMA

•• Example – LMA classicQ •• Important features - They have airway tube
and gastric tube
•• Important features - single tube present
(airway tube ), which can be used for ventilation •• They create a better seal with the larynx than
only - Demerit : cannot prevent aspiration first generation LMAs
•• They are safer and protects better against
Second generation LMA aspiration
•• Examples - LMA supreme, Proseal LMA, I gel

,84
Cerebellum Quick Revision Notes

LMA CLASSIC PROSEAL LMA
•• It is made up of Silicone
•• It is reusable / non disposable
•• Pilot balloon is present
•• It forms a good seal with the larynx preventing
aspiration of gastric contents. Hence, it is
called as ‘Proseal’
It is the LMA preferred for Day care Surgery /
Laproscopic Surgery
•• First generation LMA
•• Important features - single tube present
(airway tube )
•• Demerit : cannot prevent aspiration

LMA supreme




I - gel LMA
•• Main identification feature – It does not have
a pilot balloon
•• It is made up of Thermoelastic polymer
•• Second generation LMAQ
•• Disposable

Fast track LMA or Intubating LMA
•• Made up of Silicone
•• Non disposable
•• Can be used upto 40 times
•• Pilot Balloon is present Recommended size of the laryngeal mask airway
according to the patient's body weightQ.
•• It has a special endotracheal tube used for
intubating ‘through’ the LMA Size Patient's weight
1 <5 kg
•• It is sterilized by Autoclaving
1.5 5-9 kg
2 10-19 kg
2.5 20-29 kg
3 30-49 kg
4 50-69 kg
5 Large adult, 70-100 kg
Ideal patient position preferred for intubation :
Sniffing the morning air position / barking dog
position Q

, 85
Anesthesia



Flexion of
cervical spine




Extension of
atlanto
occipital joint




Flexion at Atlantoaxial joint and extension at Atlanto- MacIntosh laryngoscope
occipital joint •• It has a Curved blade

Steps of Intubation •• It is used in Adults

1. Insert the Laryngoscope in the right corner of
the mouth
2. Sweep the tongue from right to leftQ
3. Then lift the laryngoscope
4. 
Once the vocal cords are seen pass the
endotracheal tube
5. Inflate the cuff of the endotracheal tube and
connect the anesthesia circuit
6. Confirm intubation by capnography (gold standard) McCoy laryngoscopeQ
or by auscultation or chest XrayQ •• It has a curved blade with a lever which helps in
lifting the epiglottis
Identification of types of
laryngoscope: (Active recall) •• It is used for difficult intubation




Millers laryngoscope
•• It has a straight blade
•• It is used in pediatric patients

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