ABSTRACT :

“Trapezius squeeze test” (TST) is a simple test to perform in which 1–2 inches of trapezius muscle is held and squeezed in full thickness and response is evaluated in the form of toe/body movement. We compared the effectiveness of the TST with the Jaw thrust (JT) as clinical indicators for optimal anaesthesia depth for PLMA insertion in spontaneously breathing children under Sevoflurane anaesthesia.

METHODS :

60 children between 2-8 years of age, weighing 10-20 kg, of ASA physical status I & II undergoing minor surgical procedures were randomly allocated to the group T (TST, n=30) and the group J (JT, n=30). Anaesthesia was induced using 4% Sevoflurane in O2. As the child lost the eyelash reflex, TST or JT was performed in respective group & repeated every 15 sec till it became negative. When it became negative, a well lubricated size 2 PLMA was inserted. End tidal and MAC value of Sevoflurane at the time of PLMA insertion; Insertion time and Ease of PLMA insertion; complications and hemodynamic parameters were recorded.

RESULTS : In Group T, Mean time for TST to become negative was 4.48±0.6 minutes and insertion condition was excellent in 30 patients (100%) compared to 4.85±0.71 minutes and excellent condition in 27 patients (90%) in group J. In group T, PLMA was successfully inserted in 1st attempt in 100 % while in 97% in group J. Coughing was observed in 2 patients in group J. CONCLUSIONS :

TST provides excellent conditions and higher success rate of PLMA insertion in spontaneously breathing children without any untoward effects and can be used as an alternative to jaw thrust manoeuvre.