Intubation through a supraglottic airway device with cervical spine immobilisation: a comparison between the intubating laryngeal mask airway and the intubating laryngeal tube used by novices - a manikin study.

2017 ◽  
Vol 12 ◽  
pp. 21-22
Author(s):  
D. Aleksandrowicz ◽  
T. Gaszynski
Keyword(s):  
Cervical Spine ◽  
Laryngeal Mask Airway ◽  
Laryngeal Tube ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Supraglottic Airway Device ◽  
Manikin Study ◽  
Intubating Laryngeal Mask Airway

scholarly journals A Comparative Study of Laryngeal Mask Airway and Air-Q Intubating Laryngeal Airway Using Parker Flex Tip Tube

2020 ◽  
Vol 5 (1) ◽  
pp. 149-152
Author(s):  
Sanjay Melville Masih ◽  
Rakesh Kumar Gupta
Keyword(s):  
Laryngeal Mask Airway ◽  
Endotracheal Intubation ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Intubating Laryngeal Mask Airway ◽  
Study Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: To facilitate tracheal intubation, intubating laryngeal mask airway(ILMA) was designed specifically. A relatively new supraglottic airway device, air-Q ILA is an alternative to ILMA to facilitate endotracheal intubation. Considering advantages of air-Q over ILMA are that the breathing tube of the device is shorter, wider and due to removable connector, a standard e Parker Flex Tip tracheal tube (product of Parker Medical Company) has a curved, centered, flexible and tapered distal tip that is designed to facilitate easy, rapid and non-traumatic intubation. It has double murphy eyes with an anterior curvature and a posterior opening bevel. It is designed so that the posterior bevel will decrease the incidence of the tube catching at the anterior or the lateral laryngeal structures during tracheal intubation.Subjects and Methods: This is a randomized, single-blind study. Total of 100 patients of either sex aged 18–60 years belonging to American Society of Anaesthesiologists (ASA) physical status I or II scheduled for elective surgery under general anesthesia with endotracheal intubation were included in the study and the patients with respiratory or pharyngeal pathology, mouth opening < 2.5 cm, body mass index ≥35 kg/m2, pregnancy and anticipated difficult airway were excluded from the study. The duration of the study was one year. The ethical clearance was taken from the institutional ethical committee. Written informed consent from all participants was obtained for participation in the study. Results: A total of 100 patients were allocated for the study. The insertion of the airway device was successful in all the patients of group 1. So, 50  patients were analysed for intubation in group 1. Air-Q ILA could not be inserted and resulted in failure in two cases. Hence, 48 patients were analysed statistically for intubation in group 2. The two groups were comparable with respect to age, weight and sex distribution. The mean age of patients in group 1 was 40.00 ± 10.76 years and in group 2 it was 40.56 ± 11.0 years (P = 0.651). There were 30 females and 20 males both in group 1 and group 2 (P = 1.000). The mean weight of patients in group 1 was 60.34 ± 8.06 kg and in group 2 was 60.10 ± 10.05 kg (P = 0.924). Conclusion:The  overall success rate using Parker Flex Tip tube was more with ILMA (99%) as compared to air-Q ILA (78%). It can be further suggested that Parker Flex Tip tube can be used as an alternative to silicone tube with ILMA, but more multicentre studies are required over larger populations to evaluate the utility of Parker Flex Tip tube with air-Q ILA.

scholarly journals Predictors and Clinical Outcomes from Failed Laryngeal Mask Airway Unique™

2012 ◽  
Vol 116 (6) ◽  
pp. 1217-1226 ◽  
Author(s):  
Satya Krishna Ramachandran ◽  
Michael R. Mathis ◽  
Kevin K. Tremper ◽  
Amy M. Shanks ◽  
Sachin Kheterpal
Keyword(s):  
Laryngeal Mask Airway ◽  
Primary Outcome ◽  
Hospital Admissions ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Mask Ventilation ◽  
Supraglottic Airway Device ◽  
Respiratory Events ◽  
Unplanned Hospital Admissions

Background Although the estimated risk of life-threatening adverse respiratory events during supraglottic airway device use is rare, the reported rate of events leading to failure of the airway device is 0.2-8%. Little is known about the risk-adjusted prediction of Laryngeal Mask Airway failure requiring rescue tracheal intubation and its impact on patient outcomes. Methods All adult patients in whom a laryngeal mask airway (LMA Unique™, uLMA™; LMA North America, Inc., San Diego, CA) was used in ambulatory and nonambulatory anesthesia settings were included. The primary outcome was uLMA™ failure, defined as an airway event requiring uLMA™ removal and tracheal intubation. The secondary outcomes were the incidence of difficult mask ventilation and unplanned hospital admissions. Results Of the 15,795 cases included in our study, 170 (1.1%) experienced the primary outcome of uLMA™ failure. More than 60% of patients with uLMA™ failure experienced significant hypoxia, hypercapnia, or airway obstruction, whereas 42% presented with inadequate ventilation related to leak. Four independent risk factors for failed uLMA™ were identified: surgical table rotation, male sex, poor dentition, and increased body mass index. A 3-fold increased incidence of difficult mask ventilation was observed in patients with uLMA™ failure. Among outpatients with uLMA™ failure, 13.7% had unplanned hospital admission, 5.6% of whom needed intensive care for persistent hypoxemia. Conclusions The study supports the use of the uLMA™ as an effective supraglottic airway device with a relatively low failure rate. However, there are clinically relevant consequences of uLMA™ failure, as evidenced by the high rate of acute respiratory events and need for unplanned hospital admissions.

scholarly journals A comparative study on the perfomance between I-gel® and Classic laryngeal mask airway in anaesthetized spontaneously breathing patients

2021 ◽  
Vol 8 (3) ◽  
pp. 465-471
Author(s):  
Leno Ninan Jacob ◽  
Jaimy Mathew
Keyword(s):  
Laryngeal Mask Airway ◽  
Perioperative Complications ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Leak Pressure ◽  
Supraglottic Airway Device ◽  
Hemodynamic Changes ◽  
Group I ◽  
Classic Laryngeal Mask Airway

The classic Laryngeal Mask Airway (c-LMA) is a first generation supraglottic airway device with an inflatable cuff forming a low pressure seal around the laryngeal inlet and permitting ventilation. I-gel is a supraglottic airway device made of thermoplastic elastomer which is soft gel-like and transparent. Unlike the classic LMA(c-LMA), I-gel does not have an inflatable cuff. In view of this, the present study was undertaken to compare the performance of the two supraglottic airway devices in spontaneously breathing adult patients posted for elective surgeries under general anesthesia.To compare the ease of insertion, number of insertion attempts, time for insertion, airway leak pressure, hemodynamic changes as well as perioperative complications such as cough sore throat between patients using the two devices.Sixty patients admitted in SRM medical college and research center scheduled for various elective surgical procedures under general anesthesia belonging to ASA class I and II were included in the study. They were randomly divided into two groups of 30 each using a random number generator. In group I, I-gel supraglottic airway device was used and in Group 2 classic laryngeal mask airway was used. Data was collected using a questionair containing socio-demographic details, details regarding performance of the device as well as hemodynamic changes and perioperative complications.The insertion was easy in 25 patients (83.3%) in group I, while in group II 15 patients (50%) had easy insertion. P=0.0 1781. The mean time of insertion for I-gel was (20. 17± 3 .91 seconds) which was significantly shorter compared to c-LMA (26.80 ±7.24 seconds) (P&#60;0.001).There was no statistically significant difference between the devices with respect to number of attempts of insertion. Even though the airway leak pressure is not statically significant, the mean oropharyngeal leak pressure for I-gel was 20.40±5.68 (mm Hg), which was higher than c-LMA 18.73±5.06 (mm Hg), which is well within the normal limits to prevent aspiration. There were no statistically significant differences in hemodynamic changes. No Blood staining was seen after removal of device in I-gel group where it was observed in 2 (7%) patients in c- LMA group. Post removal cough was more in c -LMA (13 .3%) than l-gel (P= 0.04 SS*). Pharyngo-Laryngeal morbidity was more with classic LMA. Sore throat was more with the classic LMA (13 .3%) when compared to I-gel group (3%).We conclude that I-gel is a better airway when compared to c-LMA with respect to ease of insertion, shorter duration for insertion, adequate oropharyngeal seal with lesser pharyngo-laryngeal morbidity and less incidence of airway trauma.

TRACHEAL INTUBATION DURING MANUAL INLINE STABILISATION: COMPARISON OF INTUBATING LARYNGEAL MASK AIRWAY™ VERSUS TRACHLIGHT®

2021 ◽  
pp. 60-62
Author(s):  
Manjunath Prabhu ◽  
Shwethapriya Rao ◽  
Arushi Gupta
Keyword(s):  
Cervical Spine ◽  
Laryngeal Mask Airway ◽  
Tracheal Intubation ◽  
Laryngeal Mask ◽  
P Value ◽  
Stabilization Method ◽  
Intubating Laryngeal Mask Airway ◽  
Effective Ventilation ◽  
Unstable Cervical Spine ◽  
Spine Movement

Introduction: Airway management with unstable cervical spine is a major challenge to anesthetist. Conventional direct laryngoscopy causes substantial movement of cervical spine and can cause neurological decit. Newer devices like Intubating Laryngeal Mask Airway(ILMA) and Trachlight avoid cervical spine movement. To compare rate of successful tracheal Aim: intubation with Intubating Laryngeal Mask Airway™ with Trachlight® in anaesthetised and paralysed adults with manual in line stabilization Method and Materials: 50 patients were included in the study and allocated in two groups. In the ILMA group ,patients were ventilated and then intubated through the ILma. IN the Trachlight group, patients were intubated using trachlight. Success rate , time taken for intubation and post operative sore throat and hoarseness of voice were compared between the two groups. Results: In the ILMA group,21 patients could be adequately ventilated in the rst attempt and 4 in second attempt. 12 patients could be successfully intubated. 9 patients could be intubated in the rst attempt and 3 patients in second attempt. In the Trachlight , 24 patients could be intubated in the rst attempt and one patient in second attempt. Intubation time was 14.08 ± 2.23 seconds in the ILMA group whereas in Trachlight group it was 26.48 ± 9.13 seconds(p value of <0.0001) In healthy anaesthetized,paralysed adults with manual in line stabiliz Conclusion: ation Trachlight assistance at tracheal intubation provides high rst attempt success.ILMA is an effective ventilation device, but an unacceptably high failure rate at blind tracheal intubation.

scholarly journals Comparison of I-Gel and classic Laryngeal Mask Airway in paediatric population: a parallel group study

2016 ◽  
Vol 3 (2) ◽  
pp. 80-83
Author(s):  
Shanta Sapkota ◽  
Pawan Kumar Hamal ◽  
Sadicchya Shah Malla
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Pressure ◽  
Paediatric Population ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Parallel Group Study ◽  
Parallel Group ◽  
Improved Stability ◽  
Classic Laryngeal Mask Airway

Background: I-gel, the novel Supraglottic airway device, is easier to insert, has improved stability after insertion with reduced tissue compression.The study aims to compare the efficacy of I-gel with classic Laryngeal Mask Airway in the paediatric population.Methods: A randomised parallel group study was done in Department of Anesthesiology, Kanti Children Hospital, Kathmandu for a period of three months. I gel and classic LMA was compared based on leak airway pressure, time of insertion and ease of insertion.Results: Age and weight are comparable among groups. Compared to cLMA, I-gel provides a better leak pressure seal (16.40+-3.42 vs. 23.11+- 6.17 cm of H2O, p 0.027), faster time of insertion (19.42+-4.40 vs. 29.84+-7.70 seconds, p-0.02) and similar ease of insertion (p-0.571).Conclusions: I-gel compared to classic Laryngeal Mask Airway provides better resistance to leak airway pressure, faster time of insertion with comparable ease of insertion.

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