scholarly journals Bougie-guided insertion of the ProSeal™ laryngeal mask airway has higher first attempt success rate than the digital technique in children

2006 ◽  
Vol 96 (2) ◽  
pp. 238-241 ◽  
Author(s):  
M Lopez-Gil ◽  
J Brimacombe ◽  
L Barragan ◽  
C Keller
Keyword(s):  
Laryngeal Mask Airway ◽  
Success Rate ◽  
Laryngeal Mask ◽  
Digital Technique

scholarly journals Comparison of videolaryngoscope-guided versus standard digital insertion techniques of the ProSeal™ laryngeal mask airway: a prospective randomized study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ulku Ozgul ◽  
Feray Akgul Erdil ◽  
Mehmet Ali Erdogan ◽  
Zekine Begec ◽  
Cemil Colak ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Success Rate ◽  
Primary Outcome ◽  
Randomized Study ◽  
Peak Inspiratory Pressure ◽  
Laryngeal Mask ◽  
Tube Placement ◽  
Insertion Technique ◽  
Digital Technique ◽  
Insertion Techniques

Abstract Background This study were designed to investigate the usefulness of the videolaryngoscope-guided insertion technique compared with the standard digital technique for the insertion success rate and insertion conditions of the Proseal™ laryngeal mask airway (PLMA). Methods Prospective, one hundred and nineteen patients (ASA I–II, aged 18–65 yr) were randomly divided for PLMA insertion using the videolaryngoscope-guided technique or the standard digital technique. The PLMA was inserted according to the manufacturer’s instructions in the standard digital technique group. The videolaryngoscope-guided technique was performed a C-MAC® videolaryngoscope with D-Blade, under gentle videolaryngoscope guidance, the epiglottis was lifted, and the PLMA was advanced until the tip of the distal cuff reached the oesophagus inlet. The number of insertion attempts, insertion time, oropharyngeal leak pressure, leak volume, fiberoptic bronchoscopic view, peak inspiratory pressure, ease of gastric tube placement, hemodynamic changes, visible blood on PLMA and postoperative airway morbidity were recorded. Results The first-attempt success rate (the primary outcome) was higher in the videolaryngoscope-guided technique than in the standard digital technique (p = 0.029). The effect size values with 95% confidence interval were 0.19 (0.01–0.36) for the first and second attempts, 0.09 (− 0.08–0.27) for the first and third attempts, and not computed for the second and third attempts by the groups, respectively. Conclusion Videolaryngoscope-guided insertion technique can be a help in case of difficult positioning of a PLMA and can improve the PLMA performance in some conditions. We suggest that the videolaryngoscope-guided technique may be a useful technique if the digital technique fails. Trial registration ClinicalTrials.gov NCT03852589 date of registration: February 22th 2019.

Intubating Laryngeal Mask Airway

2002 ◽  
Vol 30 (5) ◽  
pp. 551-569 ◽  
Author(s):  
G. Caponas
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Difficult Airway ◽  
Success Rate ◽  
Laryngeal Mask ◽  
Oesophageal Perforation ◽  
Clinical Consequence ◽  
Neutral Position ◽  
Valuable Adjunct ◽  
Intubating Laryngeal Mask Airway

The Intubating Laryngeal Mask Airway (ILMA) was introduced into clinical practice in 1997 following numerous clinical trials involving 1110 patients. The success rate of blind intubation via the device after two attempts is 88% in “routine” cases. Successful intubation in a variety of difficult airway scenarios, including awake intubation, has been described, with the overall success rate in the 377 patients reported being approximately 98%. The use of the ILMA by the novice operator has also been investigated with conflicting reports as to its suitability for emergency intubation in this setting.Blind versus visualized intubation techniques have also been investigated. These techniques may provide some benefits in improved safety and success rates, although the evidence is not definitive. The use of a visualizing technique is recommended, especially whilst experience with intubation via the ILMA is being gained. The risk of oesophageal intubation is reported as 5% and one death has been described secondary to the complications of oesophageal perforation during blind intubation. Morbidity described with the use of the ILMA includes sore throat, hoarse voice and epiglottic oedema. Haemodynamic changes associated with intubation via the ILMA are of minimal clinical consequence.The ILMA is a valuable adjunct to the airway management armamentarium, especially in cases of difficult airway management. Success with the device is more likely if the head of the patient is maintained in the neutral position, when the operator has practised at least 20 previous insertions and when the accompanying lubricated armoured tube is used.

scholarly journals Suction catheter guided insertion of the ProSeal™ laryngeal mask airway is superior to the digital technique

2006 ◽  
Vol 53 (4) ◽  
pp. 398-403 ◽  
Author(s):  
Roberto García-Aguado ◽  
Juan Viñoles ◽  
Joseph Brimacombe ◽  
Miguel Vivó ◽  
Rosario López-Estudillo ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Laryngeal Mask ◽  
Suction Catheter ◽  
Digital Technique

scholarly journals Comparison of the Jcerity Endoscoper Airway with the LMA Supreme for Airway Management in Patients Undergoing Cerebral Aneurysm Embolization

2021 ◽  
Author(s):  
Junfei Zhou ◽  
Lu Li ◽  
Fang Wang ◽  
Yunqi Lv
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Success Rate ◽  
Cerebral Aneurysm ◽  
Cerebral Aneurysms ◽  
Laryngeal Mask ◽  
Aneurysm Embolization ◽  
Perioperative Anticoagulation ◽  
Lma Supreme ◽  
Sealing Pressure

Abstract Background Interventional embolization of cerebral aneurysms often requires anticoagulation and antiplatelet therapy during perioperative period. A new type of laryngeal mask airway (Jcerity Endoscoper Airway)with a unique design may cause less oropharyngeal injury and bleeding for patients receiving perioperative anticoagulation. This study sought to compare the efficacy, safety and complications of Jcerity Endoscoper airwayvs LMA((Laryngeal Mask Airway) Supreme in the procedure of cerebral aneurysm embolization. Methods In this prospective, randomised clinical trial, 182 adult patients with American Society of Anesthesiologists class Ι-II scheduled for interventional embolization of cerebral aneurysms were randomly allocated into the Jcerity Endoscoper airway group and the LMA Supreme group. We compared success rate of LMA implantation, ventilation quality, airway sealing pressure, peak airway pressure, degree of blood staining, postoperative oral hemorrhage, sore throat and other complications between the groups. Results There were no significant differences between the groups in terms of success rate of LMA implantation, ventilation quality, airway sealing pressure or airway peak pressure. The LMA Supreme group showed a significantly higher degree of blood staining than the Jcerity Endoscoper airway group when the laryngeal mask airway was removed (P = 0.04), and there were also more oral hemorrhages and pharyngeal pain than in the the Jcerity Endoscoper airway group (P = 0.03,P = 0.02). No differences were observed between groups in terms of other complications related to the LMA. Conclusions The Jcerity Endoscoper airway can be safely and effectively used for airway management in patients undergoing cerebral aneurysm embolization, which can significantly reduce airway complications related to perioperative anticoagulation.

Airway Management with the Laryngeal Mask Airway (LMA) in Emergency Medical Services

2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S8-S11
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Oxygen Saturation ◽  
Emergency Medical Services ◽  
Success Rate ◽  
Laryngeal Mask ◽  
High Success Rate ◽  
Medical Services ◽  
Supraglottic Airway ◽  
Emergency Medical

Background: Airway management is an important aspect of care in emergency medical services (EMS) used to prevent obstruction of the respiratory track and inadequate oxygenation. The laryngeal mask airway (LMA) is an easy-to-use supraglottic airway device developed in 1988 that has a high success rate in both adults and children. However, there have yet been no studies regarding LMA use in EMS in Thailand. Objective: To determine the success rate of LMA in EMS and factors associated with successful LMA insertion. Materials and Methods: This was a cross-sectional study consisting of Srinagarind Hospital EMS patients over 18 years of age who underwent LMA airway management between March 2016 and March 2020. Data were collected from the Srinagarind Hospital EMS operation database and hospital information database system. Results: A total of 154 patients were enrolled with a mean age of 43.1+8.5 years, 89 (57.8%) of whom were male. Non trauma patients accounted for 72.7% of all cases. The average oxygen saturation before and after LMA use were 71.4+12.3% and 94.4+3.2%, respectively (p = 0.022). Students in their first and third year of residency training were able to successfully perform LMA airway management on the first attempt in 83.3% and 98.4% of cases, respectively (p = 0.025). Conclusion: Airway management using the LMA had a high success rate on the first attempt, required less time for insertion than other comparable devices, and resulted in a high level of oxygen saturation. Keywords: Laryngeal mask airway, Emergency medical services, Airway management, Internship and residency

Gum Elastic Bougie-guided Insertion of the ProSeal™ Laryngeal Mask Airway Is Superior to the Digital and Introducer Tool Techniques

2004 ◽  
Vol 100 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Joseph Brimacombe ◽  
Christian Keller ◽  
Dana Vosoba Judd
Keyword(s):  
Laryngeal Mask Airway ◽  
Occult Blood ◽  
Proseal Laryngeal Mask Airway ◽  
Laryngeal Mask ◽  
Drain Tube ◽  
Laryngeal Mask Airway Insertion ◽  
Test Results ◽  
Digital Technique ◽  
End Tidal ◽  
Digital Or

Background The authors compare three techniques for insertion of the ProSeal laryngeal mask airway. Methods Two hundred forty healthy patients aged 18-80 yr were randomly allocated for ProSeal laryngeal mask airway insertion using the digital, introducer tool (IT), or gum elastic bougie (GEB)-guided techniques. The digital and IT techniques were performed according to the manufacturer's instructions. The GEB-guided technique involved priming the drain tube with the GEB, placing the GEB in the esophagus under direct vision, and inserting the ProSeal laryngeal mask airway using the digital technique with the GEB as a guide. Failed insertion was defined by any of the following criteria: (1) failed pharyngeal placement; (2) malposition (air leaks, negative tap test results, or failed gastric tube insertion if pharyngeal placement was successful); and (3) ineffective ventilation (maximum expired tidal volume < 8 ml/kg or end-tidal carbon dioxide > 45 mmHg if correctly positioned). Any visible or occult blood was noted. Sore throat, dysphonia, and dysphagia were assessed 18-24 h postoperatively. Results Insertion was more frequently successful with the GEB-guided technique at the first attempt (GEB, 100%; digital, 88%; IT, 84%; both P < 0.001), but success after three attempts was similar (GEB, 100%; digital, 99%; IT, 98%). The time taken to successful placement was similar among groups at the first attempt but was shorter for the GEB-technique after three attempts (GEB, 25 +/- 14 s; digital, 33 +/- 19 s; IT, 37 +/- 25 s; both: P < 0.003). There were no differences in the frequency of visible blood, but occult blood occurred less frequently with the GEB-guided technique (GEB, 12%; digital, 29%; IT, 31%; both: P < 0.02) but was similar among techniques if insertion was successful at the first attempt. There were no differences in postoperative airway morbidity. CONCLUSION The GEB-guided insertion technique is more frequently successful than the digital or IT techniques. The authors suggest that the GEB-guided technique may be a useful backup technique for when the digital and IT techniques fail.

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