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Kaur N, Saini S, Gupta A. Comparative evaluation of blind supraglottic airway device insertion versus videolaryngoscope-guided technique in adults undergoing laparoscopic cholecystectomy. Expert Rev Med Devices 2024; 21:317-324. [PMID: 38623726 DOI: 10.1080/17434440.2024.2343423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/20/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES A videolaryngoscope may decrease the high incidence of aberrant positioning of supraglottic airway devices (SAD) inserted with blind techniques. We aimed to compare Igel insertion characteristics between blind and videolaryngoscope-assisted techniques. METHODS In this study 70 adult patients scheduled for elective laparoscopic cholecystectomy under general anesthesia were randomly divided into blind (Group B, n = 35) and videolaryngoscope-guided (Group V, n = 35) Igel insertion. Oropharyngeal leak pressure (OLP), fiber-optic view score, time for device insertion, first attempt success, ease of insertion, ventilation score, maneuvers, and adverse events were assessed. RESULTS OLP was significantly higher in group V at 1 and 10 minutes (24.80 ± 1.91 vs 21.71 ± 2.37; p < 0.001 and 32.60 ± 2.32 vs 30.68 ± 2.93; p = 0.006). The mean fiberoptic scoring (3.63 ± 0.49 vs 3.38 ± 0.49; p = 0.043), a fibreoptic score of grade 4 (24 vs 13; p = 0.012) and time-to-device insertion (25.6 ± 3.5 vs 21.7 ± 4.1; p < 0.001) was considerably higher in group V. First-attempt success (p = 0.630), ease of insertion of SAD (p = 0.540) and nasogastric tube (p = 1), ventilation score (p = 1), number of maneuvers required (p = 1), number of attempts (p = 0.592) and postoperative complications (p = 0.800) were comparable in the two groups. CONCLUSION The videolaryngoscope-guided technique provided superior airway sealing and reduced malposition of Igel without an increase in adverse events compared to the blind technique. However, this was at the cost of increased time of device insertion. CLINICAL TRIAL REGISTRATION www.ctri.nic.in identifier is CTRI/2022/10/046269.
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Affiliation(s)
- Navdeep Kaur
- Department of Anesthesiology and Intensive Care, VMMC and SJH Hospital, Delhi, India
| | - Suman Saini
- Department of Anesthesiology and Intensive Care, VMMC and SJH Hospital, Delhi, India
| | - Anju Gupta
- Department of Anesthesia, Pain Medicine, and Critical Care, AIIMS, New Delhi, India
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Raman R, Prabha R, Rampal S, Tiwari T, Gautam S, Prakash R. Comparison of clinical performance of Baska mask and Ambu AuraGain in patients undergoing surgery: A single-blinded, randomised comparative trial. Indian J Anaesth 2023; 67:S227-S231. [PMID: 38187974 PMCID: PMC10768903 DOI: 10.4103/ija.ija_152_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/02/2023] [Accepted: 05/09/2023] [Indexed: 01/09/2024] Open
Abstract
Background and Aims The Baska mask (BM) and the Ambu AuraGain (AAG) have shown promising results in recent trials but have not been compared. Therefore, we aimed to compare the clinical performance of the BM and the AAG for airway management of adult patients. Methods In this randomised comparative study, patients aged 18-60 years and with an expected surgical duration of less than 2 h were enroled. Patients were randomly allocated to AAG (Group A, n = 37) and BM (Group B, n = 37) for airway management. After induction of anaesthesia, an allocated supraglottic airway device (SAD) was inserted. Oropharyngeal leak pressure (OLP), time taken to insert SAD, number of insertion attempts, leak fraction (LF), first-attempt success rate, overall success rate, ease of insertion, fiberoptic view of the glottis, and complications were compared. The data were analysed using Student's t-test, Mann-Whitney U test, and Fisher's exact tests. Results Baseline and demographic characteristics were comparable. OLP (31.32 ± 2.59 versus 27.54 ± 1.32 cmH2O) was higher (P < 0.001), and LF (6.19% ± 1.20% versus 7.24% ± 1.72%) was lower (P = 0.003) in the BM group. First-attempt and overall success rate, time taken to insert, number of insertion attempts, ease of insertion, and fibreoptic view of glottis through the SADs were statistically similar between groups. However, the incidence of sore throat (P = 0.007) and cough (P = 0.028) was higher with AAG. Conclusion Clinical performance of BM was better than AAG as the former had higher OLP, lower LF and complications.
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Affiliation(s)
- Rajesh Raman
- Department of Anaesthesiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Rati Prabha
- Department of Anaesthesiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Surbhi Rampal
- Department of Anaesthesiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Tanmay Tiwari
- Department of Anaesthesiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Shefali Gautam
- Department of Anaesthesiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Ravi Prakash
- Department of Anaesthesiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
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Kumar B, Gupta B, Thakur A, Rana S, Garg M, Nehria M. Comparative evaluation of airway dynamics in patients undergoing laparoscopic cholecystectomy under general anaesthesia with controlled ventilation using ProSeal laryngeal mask airway, I-Gel™ and Baska mask. Indian J Anaesth 2022; 66:842-848. [PMID: 36654901 PMCID: PMC9842078 DOI: 10.4103/ija.ija_827_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 11/23/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Background and Aims TheProSeal™ laryngeal mask airway (PLMA) and I-Gel™ are second-generation supraglottic airway devices (SADs). The Baska mask is a SAD having a non-inflatable cuff with a tendency to increase the perilaryngeal seal with an increase in airway pressures. This study compared the efficacy of I-Gel™, PLMA and Baska mask with respect to airway dynamics in patients scheduled for laparoscopic surgeries under general anaesthesia (GA). Methods Ninety patients, of American Society of Anesthesiologists physical status I and II, aged 20-65 years scheduled for laparoscopic cholecystectomy under GA were enroled. The patients were randomised into three groups: Group P (n = 30): airway secured using PLMA, Group I (n = 30): airway secured using I-Gel™ and Group B (n = 30): airway secured using Baska mask. The primary outcome was the change in dynamic compliance, and the secondary outcomes included insertion time, changes in peak inspiratory pressure (PIP) and oropharyngeal leak pressure (OLP) at different time intervals. Results After insertion of the SADs, the dynamic compliance was highest in group B and least in the group I (p = 0.01). The maximum decrease in dynamic compliance was observed in group I. The insertion time for SAD placement was more in group P. The group B had least PIP as compared to groups P, I at insertion. After carboperitonium, groups P and B had comparable PIP, and group I had highest PIP (p = 0.001). OLP was highest in group B, whereas group I had least OLP. Conclusion The airway dynamics are better maintained with Baska mask as compared to the PLMA and I-Gel™.
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Affiliation(s)
- Brijender Kumar
- Department of Anaesthesia, Dr. Rajendra Prasad Medical College, Kangra at Tanda, Himachal Pradesh, India
| | - Bhanu Gupta
- Department of Anaesthesia, Dr. Rajendra Prasad Medical College, Kangra at Tanda, Himachal Pradesh, India
| | - Aman Thakur
- Department of Anaesthesia, Dr. Rajendra Prasad Medical College, Kangra at Tanda, Himachal Pradesh, India
| | - Shelly Rana
- Department of Anaesthesia, Dr. Rajendra Prasad Medical College, Kangra at Tanda, Himachal Pradesh, India,Address for correspondence: Dr. Shelly Rana, Department of Anaesthesia, Dr. Rajendra Prasad Medical College, Kangra at Tanda, Himachal Pradesh - 176 001, India. E-mail:
| | - Mohini Garg
- Department of Anaesthesia, Dr. Rajendra Prasad Medical College, Kangra at Tanda, Himachal Pradesh, India
| | - Maninder Nehria
- Department of Anaesthesia, Dr. Rajendra Prasad Medical College, Kangra at Tanda, Himachal Pradesh, India
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Hussain D, Kundal R, Kumar A, Sabharwal N. An Analysis of the Comparative Efficacy Between a Third-Generation and a Second-Generation Supraglottic Airway Device in Patients Undergoing Laparoscopic Cholecystectomy. Cureus 2022; 14:e22592. [PMID: 35355545 PMCID: PMC8957779 DOI: 10.7759/cureus.22592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2022] [Indexed: 11/05/2022] Open
Abstract
Background and objective Supraglottic airway devices are extensively used nowadays to secure the airway and minimize postoperative airway-related complications. This study aimed to evaluate whether the Baska® mask (BM) provides higher seal pressure and a better first-time insertion compared to the laryngeal mask airway (LMA) ProSeal™ (LMA-P) in adult laparoscopic cholecystectomy. Methodology This prospective, randomized, single-blinded interventional study was performed after obtaining ethical approval from the Institutional Ethics Committee at the Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. Sixty adult patients of both genders scheduled for laparoscopic cholecystectomy under general anesthesia were divided into two groups, with 30 patients in each group. Our study observed the number of insertion attempts, time of insertion, oropharyngeal seal pressure (OSP), number of patients requiring manipulation for proper placement of supraglottic airway devices, and ease of insertion. Results There were no significant differences in terms of insertion attempts, ease of insertion, and laryngopharyngeal morbidity between the groups. The mean OSP at five minutes was 31.55 ±2.23 cm H2O, and that at 30 minutes was 35.86 ±3.70 cm H20 in the BM group, while in the LMA-P group, it was 24.17 ±3.74 cm H20 and 25.97 ±3.79 cm H20 respectively (p<0.001). In our study, the trend of OSP continued to increase in the BM group more than in the LMA-P group during surgery. Conclusion The BM provided better OSP than the LMA-P, which was observed throughout the surgery.
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Ari DE, Abitagaoglu S, Koksal C, YildirimAr A, Emrem D, Ustun M. Comparison of I-gel and LMA Protector in Laparoscopic Cholecystectomy: A Randomized Controlled Trial. Niger J Clin Pract 2022; 25:90-96. [PMID: 35046201 DOI: 10.4103/njcp.njcp_693_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aims Comparison of the use of I-gel and Laringeal Mask Airway (LMA) Protector in laparoscopic cholecystectomy regarding the time and ease of insertion for supraglottic airway devices (SAD) and gastric tube (GT), airway sealing capacity, and postoperative complications. Patients and Methods Sixty-four American Society of Anaesthesiologists (ASA) I-III patients undergoing laparoscopic cholecystectomy were randomly allocated into two groups. After anesthesia induction, LMA Protector was inserted in Group LPRO (LMA Protector) (n = 33) and I-gel was inserted in Group IGEL (I-gel) (n = 31) patients. Time of SAD insertion, number of attempts, time, and ease of GT insertion were recorded. The peak inspiratory pressure (PIP) and oropharyngeal leak pressure (OLP) were measured at the time of SAD insertion, 10 min after insertion, 10 min after pneumoperitoneum, and just before the termination of pneumoperitoneum. The presence of bloodstains on SAD, sore throat, hoarseness, nausea, and pain in swallowing was assessed postoperatively. A P value of < 0.05 was accepted as statistically significant. Result Two patients in Group LPRO needed endotracheal intubation and were excluded from the study. The SAD insertion time was shorter in Group IGEL than in Group LPRO (13 ± 7.4 s vs. 18.8 ± 9.8 s). The number of attempts and success rate on the first attempt were similar in both groups. GT insertion time was shorter in Group IGEL than Group LPRO (11 ± 7.7 s vs. 21 ± 11 s). The insertion of GT was easier in Group IGEL. The OLP levels decreased during the pneumoperitoneum in Group LPRO while they remained constant in Group IGEL. Conclusion We observed that I-gel offers more stable airway sealing and easier GT insertion advantages when compared with LMA Protector in laparoscopic cholecystectomy.
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Affiliation(s)
- D E Ari
- Department of Anesthesiology and Reanimation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - S Abitagaoglu
- Department of Anesthesiology and Reanimation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - C Koksal
- Department of Anesthesiology and Reanimation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - A YildirimAr
- Department of Anesthesiology and Reanimation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - D Emrem
- Department of Anesthesiology and Reanimation, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, Istanbul, Turkey
| | - M Ustun
- Department of Anesthesiology and Reanimation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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Rai S, Sharma P, Tripathi M, Malviya D, Kumari S, Mishra S. Comparison of LMA supreme, i-gel, and baska mask for airway management during laparoscopic cholecystectomy: A prospective randomized comparative study from North India. Anesth Essays Res 2022; 16:42-48. [PMID: 36249140 PMCID: PMC9558661 DOI: 10.4103/aer.aer_23_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/27/2022] [Accepted: 05/06/2022] [Indexed: 11/28/2022] Open
Abstract
Background: The supraglottic airway device (SAD) has proved to be an appropriate alternative to endotracheal intubation in laparoscopic surgeries owing to various advantages, namely, decreased airway manipulation and stable hemodynamics. Aims: We compared the efficacy in terms of oropharyngeal leak pressure (OLP) and safety of laryngeal mask airway (LMA)-Supreme (LMA-S), i-gel, and Baska mask in patients undergoing laparoscopic cholecystectomy. Settings and Design: Ninety patients posted for elective laparoscopic cholecystectomy were selected for a prospective randomized comparative study in a tertiary care center. Materials and Methods: The study comprised three groups of 30 each based on the different SADs used Group-LS with LMA-Supreme, Group-IG with i-gel, and Group-BM with Baska mask. The secondary objectives were device insertion time, ease of insertion, changes in the peak airway pressure (PAP), heart rate, mean arterial pressure, and airway complications (sore throat, dysphagia. dysphonia, lip/tongue or dental injury, etc.) between three groups. Statistical Analysis: The quantitative data were analyzed using the one-way analysis of variance test and Bonferroni post hoc multiple comparison test. Qualitative data were compared using Chi.squared test Results: OLP was significantly higher (P = 0.005) in the Baska mask than i-gel and LMA-S groups just after insertion and during carboperitonium. There was no significant difference in time for device insertion, number of attempts, ease of insertion, and use of manipulation (P > 0.05). However, the gastric tube insertion time was significantly lower in Group BM (9.59 ± 2.78) than Group IG with 12.79 ± 3.47 and Group LS with 10.84 ± 3.68 (P < 0.05). There were no significant differences between the groups with regard to changes in the PAP, heart rate, mean arterial pressure at different time intervals, and complications. Conclusion: Baska mask provided a significantly higher OLP compared to i-gel and LMA-S without significant airway morbidity in laparoscopic surgeries.
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Priya H, Sripriya R, Ravishankar M, Karthikeyan P, Charulatha R. Baska Mask is non-inferior to tracheal tube in preventing airway contamination during controlled ventilation in elective nasal surgeries: A randomised controlled trial. Indian J Anaesth 2021; 65:586-592. [PMID: 34584281 PMCID: PMC8445220 DOI: 10.4103/ija.ija_237_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/26/2021] [Accepted: 08/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background and Aims: Baska Mask, a newly designed third-generation supraglottic device, has a sump where the pharyngeal secretions can collect and be suctioned out continuously. We aimed to study the effectiveness of Baska Mask in preventing airway contamination during nasal surgeries. Our primary objective was to assess airway soiling using fibreoptic bronchoscopy. Total airway manipulation time, haemodynamic parameters during device insertion and post-operative oro-pharyngeal morbidities were the secondary objectives. Methods: Eighty-four participants undergoing nasal surgeries were randomised to either have their airway maintained with Baska Mask (Group-BM) or Endotracheal tube (Group-TT). Fibreoptic bronchoscopy was performed at the end of the surgery and the airway was inspected for signs of contamination. Total airway manipulation time, haemodynamic parameters during device insertion and post-operative oro-pharyngeal morbidities were also assessed. Unpaired Student's t test was used for parametric data and Chi-square test for nonparametric data. One-way analysis of variance (ANOVA) was used for the intra-group analysis of haemodynamic data. Results: Tracheal contamination was not observed in any patient in either group. Time taken for device insertion (Group TT: 24.24 ± 6.86 s vs. Group BM: 24.22 ± 7.3 s; P = 0.97) was similar in both the groups. The total airway manipulation time was 2 min longer in Group-TT (P = 0.000) due to additional time taken for insertion of throat pack. Haemodynamic parameters during device insertion were stable and post-operative oro-pharyngeal morbidities were fewer with Baska Mask when compared to Tracheal tube. Conclusions: Baska Mask is non-inferior to tracheal tube in preventing tracheal contamination in patients undergoing nasal surgeries.
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Affiliation(s)
- H Priya
- Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
| | - R Sripriya
- Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
| | - M Ravishankar
- Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
| | - P Karthikeyan
- Department of Otorhinolaryngology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
| | - R Charulatha
- Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
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Ng CC, Sybil Shah MHB, Chaw SH, Mansor MB, Tan WK, Koong JK, Wang CY. Baska mask versus endotracheal tube in laparoscopic cholecystectomy surgery: a prospective randomized trial. Expert Rev Med Devices 2020; 18:203-210. [PMID: 33322949 DOI: 10.1080/17434440.2021.1865796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Supraglottic airway devices have increasingly been used as the airway technique of choice in laparoscopic surgeries. This study compared the efficacy and safety of the Baska Mask with endotracheal tube (ETT) in patients undergoing elective laparoscopic cholecystectomy.Research design and methods: This single-center, prospective, randomized controlled trial recruited 60 patients aged 18-75 years with American Society of Anesthesiologists' classifications I to III. The time taken to achieve effective airway, number of attempts, ease of insertion, ventilation parameters, hemodynamics data, and pharyngolaryngeal complications were recorded.Results: The time taken to achieve effective airway was shorter for the Baska group (26.6 ± 4.7 vs. 47.2 ± 11.8 s; p < 0.001), although the first-time insertion success rate was ≥90% for both groups. The ETT group experienced more pharyngolaryngeal complications, including cough, trauma, spasm, dysphonia, and sore throat, during device insertion and removal and had higher systolic and diastolic blood pressures during intubation (p = 0.001). The Baska Mask achieved significantly lower peak airway pressure (p = 0.024) with stable oropharyngeal leak pressure ≥33 cmH2O throughout the surgery.Conclusions: The Baska Mask is a suitable alternative to endotracheal intubation in selected patients undergoing laparoscopic cholecystectomy, with shorter insertion times, fewer perioperative complications, and improved ventilatory performance and hemodynamic response.Trial registration: The trial is registered at ClinicalTrials.gov (NCT03045835), 8 February 2017.
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Affiliation(s)
- Ching Choe Ng
- Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Sook Hui Chaw
- Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Marzida Binti Mansor
- Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wei Keang Tan
- Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jun Kit Koong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chew Yin Wang
- Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Park HP. Supraglottic airway devices: more good than bad. Korean J Anesthesiol 2019; 72:525-526. [PMID: 31813205 PMCID: PMC6900417 DOI: 10.4097/kja.19417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Hee-Pyoung Park
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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