ULTRA–FAST TRACKING IN ANAESTHESIOLOGY–DURING SURGERY FOR ATRIAL SEPTAL DEFECT (ASD) CLOSURE USING LARYNGEAL MASK AIRWAYS

Dr Madhusoodana R Bhovi; Dr Shridevi A.S.; Dr A.M.Jagadeesh

Volume : V, Issue : I, January - 2016

ULTRA–FAST TRACKING IN ANAESTHESIOLOGY–DURING SURGERY FOR ATRIAL SEPTAL DEFECT (ASD) CLOSURE USING LARYNGEAL MASK AIRWAYS

Dr Madhusoodana R Bhovi, Dr Shridevi A. S. , Dr A. M. Jagadeesh

Abstract :

Recently there has been much interest in early extubation following cardiac surgery, in an attempt to decrease cost of it and to reduce length of hospital stay. One popular strategy known as fast tracking uses modified anesthetic management that facilitates early ET extubation at 1 to 6 hours after surgery. Therefore, we have undertaken a protocol to determine the possibility of avoiding post operative ventilation in patients undergoing ASD closure surgeries under CPB with the use of short/intermediate acting drugs and laryngeal mask airways.25 patients undergoing ASD closure surgery were studied. Premedicated with Morphine 0.1 mg/kg i.m.1/2 an hr before surgery Or Ketamine 5mg/kg i.m. before surgery in children. Induced with fentanyl 3 mics/kg i.v.Vecuronium–1–1.5 mg/ kg i.v. Propofol 0.5 mg/kg i.v. Midazolam 0.05 mg/kg Airway maintained with LMA. Maintenance–Fentanyl 1–5 mics/kg i.v, Propofol 0.05–0.1 mg/kg i.v.,Atracurium–10mics/kg/min. Conclusions–Early extubation using short/intermediate acting drugs and LMA is a safe method in uncomplicated cardiac surgical procedures.