The new PAXpress airway device during mechanical ventilation in anaesthetized patients: a prospective, randomized comparison with the 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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Feasibility of Laryngeal Mask Airway Device Placement in Neonates

Neonatology ◽

10.1159/000450691 ◽

2016 ◽

Vol 111 (3) ◽

pp. 222-227 ◽

Cited By ~ 15

Author(s):

Amanda A. Wanous ◽

Andrew Wey ◽

Kyle D. Rudser ◽

Kari D. Roberts

Keyword(s):

Laryngeal Mask Airway ◽

Airway Device ◽

Laryngeal Mask ◽

Device Placement

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Standalone use of Laryngeal mask airway supreme for primary airway management in adults undergoing laparoscopic surgeries: A prospective observational study

MedPulse International Journal of Anesthesology ◽

10.26611/10152011 ◽

2021 ◽

Vol 20 (1) ◽

pp. 01-06

Author(s):

Sheetal K Desai ◽

Keyword(s):

Laryngeal Mask Airway ◽

Observational Study ◽

Airway Management ◽

Prospective Observational Study ◽

Operative Procedure ◽

Airway Device ◽

Laryngeal Mask ◽

Throat Pain ◽

Laparoscopic Procedures ◽

Duration Of Surgery

Background: Laryngeal mask airway (LMA) does not provide definitive airway protection from pulmonary aspiration of potential regurgitated gastric contents. LMA supreme, a recent supraglottic (extraglottic) airway device, shows promising results. Thus, aim of study to evaluate the role of supreme laryngeal mask airway (SLMA) in airway management of patients operated with laparoscopic procedures under general Anaesthesia. Methods: The prospective observational study comprised of 274 patients of ASA grade 1 and 2 scheduled for short elective laparoscopic procedures (<1hr.30min) who provided consent. Patients were anaesthetised according to standard protocol, appropriate size of SLMA was chosen and inserted; and complications were noted. Post SLMA removal, recovery and trauma of throat were noted. Postoperative complications such as nausea, vomiting, and throat pain were noted. Binary logistic regression model and Chi-square test of association was performed to analyse data (P<0.05). Results: Most participants were female (n=260) with mean age of 31.42±7.24 years. Mean duration of surgery and recovery time was 37.3±5.84 min and 5.85±1.93 min respectively. SLMA size 3 was commonly used (n=245) and majority of insertions were successful in the first attempt (n=244). Post insertion, SLMA had adequate length (n=208) Throat pain (n=37) and vomiting (n=38) were common post-operative complications observed in the patients. A significant association was observed between operative procedure and complication (P=0.0004) and number of attempts (P=0.0004) with trauma being significant (P=0.0039). Trauma was associated with gender (P=0.08) and body weight (P=0.006). Conclusion: SLMA can be used as a standalone supraglottic (extraglottic) airway device for airway management in laparoscopic surgeries.

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Flexible Lightwand–guided Tracheal Intubation with the Intubating Laryngeal Mask Fastrach TMin Adults after Unpredicted Failed Laryngoscope-guided Tracheal Intubation

Anesthesiology ◽

10.1097/00000542-200202000-00012 ◽

2002 ◽

Vol 96 (2) ◽

pp. 296-299 ◽

Cited By ~ 27

Author(s):

Vasilios Dimitriou ◽

Gregory S. Voyagis ◽

Joseph R. Brimacombe

Keyword(s):

Laryngeal Mask Airway ◽

Tracheal Intubation ◽

Median Number ◽

Airway Device ◽

Laryngeal Mask ◽

Successful Intubation ◽

Inclusion Criteria ◽

The Third ◽

Intubating Laryngeal Mask Airway ◽

Ventilatory Device

Background The authors determined the efficacy of using the intubating laryngeal mask airway Fastrach (ILM) as a ventilatory device and aid to flexible lightwand-guided tracheal intubation in patients with unpredicted failed laryngoscope-guided tracheal intubation when managed by experienced anesthetists. Methods During a 27-month period, 16 experienced anesthetists agreed to use the ILM as an airway device and airway intubator in patients (aged > 18 yr) with predicted normal airways who were subsequently found to be difficult to intubate (three failed attempts at laryngoscopy). Intubation via the ILM was performed with a flexible lightwand. The number of attempts at ILM placement, the number of adjusting maneuvers, the number of attempts at tracheal intubation via the ILM,and any episodes of hypoxia (oxygen saturation < 90%) were recorded. Results Forty-four of 11,621 patients (0.4%) met the inclusion criteria. ILM insertion and ventilation was successful at the first attempt in 40 of 44 patients (91%) and at the second attempt in 4 of 44 (9%). Flexible lightwand-guided tracheal intubation via the ILM was successful in 38 of 44 patients (86%) at the first attempt, 3 of 44 (7%) at the second attempt, 2 of 44 (5%) at the third to fifth attempts, and failed in 1 of 44 (2%). The median number of adjusting maneuvers before successful intubation was 1 (range, 0-4). Hypoxia occurred in 5 patients before ILM insertion (range, 52-82%), but none after ILM insertion. No patient developed hypoxia during or after intubation via the ILM. Conclusion The ILM is an effective ventilatory device and aid to flexible lightwand-guided tracheal intubation in adult patients with predicted normal airways in whom laryngoscope-guided tracheal intubation subsequently fails when managed by experienced anesthetists.

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WITHDRAWN: Fiber-optic evaluation of laryngeal mask airway position during controlled mechanical ventilation: Time effect

Egyptian Journal of Anaesthesia ◽

10.1016/j.egja.2014.04.004 ◽

2014 ◽

Author(s):

Hosam M. Atef ◽

Mohamed T. EL Tabakh

Keyword(s):

Mechanical Ventilation ◽

Laryngeal Mask Airway ◽

Fiber Optic ◽

Time Effect ◽

Laryngeal Mask ◽

Ventilation Time ◽

Controlled Mechanical Ventilation ◽

Mechanical Ventilation Time

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Laryngeal Mask Airway for Surfactant Administration Versus Standard Treatment Methods in Preterm Neonates with Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

American Journal of Perinatology ◽

10.1055/s-0041-1722953 ◽

2021 ◽

Author(s):

Roqaia Ayesh Al Ali ◽

Bishal Gautam ◽

Michael R. Miller ◽

Sherry Coulson ◽

Doris Yuen

Keyword(s):

Systematic Review ◽

Mechanical Ventilation ◽

Laryngeal Mask Airway ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Risk Ratio ◽

Distress Syndrome ◽

Meta Analysis ◽

Mean Difference ◽

Laryngeal Mask

Objective Laryngeal mask airway (LMA) has emerged as an alternative surfactant delivery method. The effectiveness of this method for the delivery of surfactant is uncertain. A meta-analysis of randomized control trials (RCTs) comparing LMA with standard methods of surfactant delivery for the outcomes of surfactant dose repetition, oxygen requirement, mechanical ventilation, intubation, mortality, bronchopulmonary dysplasia (BPD), and pneumothorax. Study Design Systematic review and meta-analysis of RCTs. Homogeneity between studies was analyzed by using I2 statistics. Risk ratio or mean difference of outcomes was assessed from random effects models. Subgroup analyses were conducted when necessary. Data sources are as follows: Ovid Medline, Embase, and the Cochrane Central Register of Controlled trials from inception till December 2018, bibliographies of identified reviews and trial registries for ongoing studies. RCTs comparing short-term respiratory outcomes in neonates with respiratory distress syndrome who were administered surfactant through an LMA versus standard method of care. Results Six RCTs were identified, enrolling a total of 357 infants. Administering surfactant via LMA was associated with decreased FiO2 requirement (mean difference = 1.82 (95% confidence interval [CI]: −6.01 to 9.66), decreased intubation (risk ratio [RR] = 0.17; 95% CI: 0.05–0.57), and decreased mechanical ventilation (RR = 0.44; 95% CI: 0.31–0.61). There were no significant differences between groups for death, BPD, or pneumothorax. Conclusion LMA might be an effective alternative method of surfactant delivery; however, further high-quality RCTs with larger sample size and including extreme preterm infants are needed to establish LMA as an alternative technique for surfactant delivery. Key Points

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Intubating Laryngeal Mask Airway in Morbidly Obese and Lean Patients

Anesthesiology ◽

10.1097/00000542-200506000-00008 ◽

2005 ◽

Vol 102 (6) ◽

pp. 1106-1109 ◽

Cited By ~ 63

Author(s):

Xavier Combes ◽

Stéphane Sauvat ◽

Bertrand Leroux ◽

Marc Dumerat ◽

Emanuel Sherrer ◽

...

Keyword(s):

Laryngeal Mask Airway ◽

Tracheal Intubation ◽

Airway Management ◽

Airway Device ◽

Laryngeal Mask ◽

Morbidly Obese ◽

Obese Patients ◽

Healthy Weight ◽

Management Quality ◽

Intubating Laryngeal Mask Airway

Background The intubating laryngeal mask airway (ILMA) was designed using the characteristics of healthy-weight subjects but was shown to be an effective airway device in morbidly obese patients. The authors compared airway management quality in morbidly obese and lean patients with use of the ILMA. Methods Fifty morbidly obese and 50 lean patients (mean body mass indexes, 42 and 27 kg/m, respectively) were enrolled in this prospective study. After induction of general anesthesia, characteristics of airway management were judged on safety and efficiency parameters, including success rate at ventilation and intubation and airway management quality criteria, such as the number of patients who required adjustment maneuvers, the number of failed tracheal intubation attempts, the total duration of airway management, and an overall difficulty visual analog scale score. Results The ILMA was successfully inserted and adequate ventilation through the ILMA was achieved in all 100 patients. The success rates of tracheal intubation through the ILMA were similar in obese and lean patients (96% and 94%, respectively). The numbers of failed blind tracheal access attempts and patients who required airway-adjustment maneuvers were significantly reduced in obese patients as compared with lean patients. Four obese patients experienced transient episodes of oxygen desaturation (oxygen saturation < 90%) before adequate bag ventilation was established with the ILMA. Conclusion The authors confirmed that the ILMA was an efficient airway device for airway management of both lean and obese patients. In the conditions of this study, the authors observed that airway management with the ILMA was simpler in obese patients as compared with lean patients.

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