BACKGROUND: The optimal time to remove the laryngeal mask airway (LMA) at the end of surgery is still a matter of controversy. The purpose of this study was to compare the incidence of complications associated with the removal of the LMA from the deeply anesthetized and from the awake patient. METHODS: The LMA was used in 120 adults undergoing general elective lower abdominal or extremity surgery. The patients were randomly assigned to two groups. In 60 patients the LMA was removed by the anesthetist with the patient deeply anesthetized in the operating room. In the other 60 patients it was removed by the anesthetist when the patient responded to verbal commands in the operating room. Any airway complications occurring within 15 minutes of LMA removal were recorded. These complications included coughing, biting, retching, vomiting, excessive salivation, airway obstruction and laryngospasm. RESULTS: Groups were similar in age, weight, and duration of surgery. Airway complications associated with LMA removal were noted in fourteen patients. Airway complications occurred in six patients who had their LMA removed during deep anesthesia, and in eight patients who under went removal of their LMA on awakening. In the anesthetized group, there were four kinds of airway complications in six patients (retching, excessive salivation, airway obstruction and laryngospasm). In the awake group, eight patients experienced six kinds of airway complications (coughing, biting, vomiting, excessive salivation, airway obstruction and laryngospasm). There was no significant difference between the two groups in the incidence of complications after removal of the LMA. CONCLUSIONS: Removal of the LMA under deep anesthesia had no advantage compared to removal from awakening patients in terms of complications in adult.
Adult ; Airway Obstruction ; Anesthesia* ; Anesthesia, General ; Cough ; Extremities ; Humans ; Incidence ; Laryngeal Masks* ; Laryngismus ; Operating Rooms ; Salivation ; Vomiting

BACKGROUND: The optimal time to remove the laryngeal mask airway (LMA) at the end of surgery is still a matter of controversy. The purpose of this study was to compare the incidence of complications associated with the removal of the LMA from the deeply anesthetized and from the awake patient. METHODS: The LMA was used in 120 adults undergoing general elective lower abdominal or extremity surgery. The patients were randomly assigned to two groups. In 60 patients the LMA was removed by the anesthetist with the patient deeply anesthetized in the operating room. In the other 60 patients it was removed by the anesthetist when the patient responded to verbal commands in the operating room. Any airway complications occurring within 15 minutes of LMA removal were recorded. These complications included coughing, biting, retching, vomiting, excessive salivation, airway obstruction and laryngospasm. RESULTS: Groups were similar in age, weight, and duration of surgery. Airway complications associated with LMA removal were noted in fourteen patients. Airway complications occurred in six patients who had their LMA removed during deep anesthesia, and in eight patients who under went removal of their LMA on awakening. In the anesthetized group, there were four kinds of airway complications in six patients (retching, excessive salivation, airway obstruction and laryngospasm). In the awake group, eight patients experienced six kinds of airway complications (coughing, biting, vomiting, excessive salivation, airway obstruction and laryngospasm). There was no significant difference between the two groups in the incidence of complications after removal of the LMA. CONCLUSIONS: Removal of the LMA under deep anesthesia had no advantage compared to removal from awakening patients in terms of complications in adult.
Adult ; Airway Obstruction ; Anesthesia* ; Anesthesia, General ; Cough ; Extremities ; Humans ; Incidence ; Laryngeal Masks* ; Laryngismus ; Operating Rooms ; Salivation ; Vomiting

BACKGROUND/AIMS: Inflammatory bowel disease is commonly accompanied by colonic dysmotility and causes changes in intestinal smooth muscle contractility. In this study, colonic smooth muscle contractility in a chronic inflammatory condition was investigated using smooth muscle tissues prepared from interleukin-10 knockout (IL-10(-/-)) mice. METHODS: Prepared smooth muscle sections were placed in an organ bath system. Cholinergic and nitrergic neuronal responses were observed using carbachol and electrical field stimulation with L-NG-nitroarginine methyl ester (L-NAME). The expression of interstitial cells of Cajal (ICC) networks, muscarinic receptors, neuronal nitric oxide synthase (nNOS) and inducible nitric oxide synthase (iNOS) was observed via immunofluorescent staining. RESULTS: The spontaneous contractility and expression of ICC networks in the proximal and distal colon was significantly decreased in IL-10(-/-) mice compared to IL-10(+/+) mice. The contractility in response to carbachol was significantly decreased in the proximal colon of IL-10(-/-) mice compared to IL-10(+/+) mice, but no significant difference was found in the distal colon. In addition, the expression of muscarinic receptor type 2 was reduced in the proximal colon of IL-10(-/-) mice. The nictric oxide-mediated relaxation after electrical field stimulation was significantly decreased in the proximal and distal colon of IL-10(-/-) mice. In inflamed colon, the expression of nNOS decreased, whereas the expression of iNOS increased. CONCLUSIONS: These results suggest that damage to the ICC network and NOS system in the proximal and distal colon, as well as damage to the smooth muscle cholinergic receptor in the proximal colon may play an important role in the dysmotility of the inflamed colon.
Animals ; Baths ; Carbachol ; Colon* ; Inflammatory Bowel Diseases* ; Interleukin-10* ; Interstitial Cells of Cajal ; Mice ; Mice, Knockout* ; Muscle, Smooth ; Nitrergic Neurons ; Nitric Oxide Synthase Type I ; Nitric Oxide Synthase Type II ; Receptors, Muscarinic ; Relaxation