Getting started

Anaesthetic Gases ◽

Airway Equipment ◽

This chapter provides a basic overview of anaesthetic equipment and its safe use. Topics include the provision of anaesthetic gases, the basic components of the anaesthetic machine, breathing systems, positive-pressure ventilation, and airway equipment including laryngoscopes, endotracheal tubes and supraglottic airway devices. Methods of long-term venous access are discussed.

Anaesthetic equipment

Paediatric Anaesthesia ◽

10.1093/med/9780198755791.003.0005 ◽

2019 ◽

pp. 71-100

Author(s):

Richard Craig

Keyword(s):

Near Infrared ◽

Supraglottic Airway ◽

Endotracheal Tubes ◽

Practical Advice ◽

Anaesthetic Equipment ◽

Perioperative Monitoring ◽

Airway Equipment ◽

Bis Monitor ◽

This chapter presents anaesthetic equipment used in paediatric anaesthesia. Airway equipment is described in detail with specific examples. This includes a description of the variety of supraglottic airway devices, endotracheal tubes, laryngoscopes for direct and indirect visualization of the larynx, breathing systems, ventilators, and modes of ventilation. Equipment for perioperative monitoring of the paediatric patient is reviewed. Practical advice regarding monitoring neonates and small babies is given particular attention. The use of the bispectral index (BIS) monitor and near-infrared spectroscopy (NIRS) are discussed. New advances in pulse oximetry that enable better monitoring with low perfusion states and motion are included.

Comparison of Clinical Performance of Supraglottic Airway Devices in Elderly Patients: A Prospective Randomized Trial

Journal of Anesthesiology and Reanimation Specialists’ Society ◽

10.5222/jarss.2021.27147 ◽

2021 ◽

Author(s):

Reyhan Polat ◽

Sibel Çatalca ◽

Julide Ergil ◽

İlkay Baran ◽

Aylin Tamam ◽

...

Keyword(s):

Elderly Patients ◽

Clinical Performance ◽

The Elderly ◽

Supraglottic Airway ◽

Positive Pressure ◽

Success Rates ◽

Group I ◽

Significant Difference ◽

INTRODUCTION: Airway management in the elderly may be challenging. Supraglottic airway devices (SADs) may be used to provide airway security. The aim of study was to compare the efficacy and safety of different SADs, LMA classic (c-LMA), proseal LMA (p-LMA) and i-gel in anaesthetised and non-paralysed elderly patients. METHODS: The study was approved by a local ethics committee. Eighty patients, aged older than 65 years, who were scheduled to undergo elective urological or orthopaedic surgery participated in the study. Each patient was randomly allocated into 1 of 3 groups: Group C: c-LMA (n = 26), Group P: p-LMA (n = 27) or Group I: i-gel (n = 27). The primary outcome was oropharyngeal sealing pressure (OSP). Secondary outcomes included the adequacy of positive pressure ventilation, ease of insertion, success rates, time to insertion, haemodynamic response and complications such as sore throat and dysphagia. RESULTS: There were no significant differences among the groups with respect to OSP (p=0.852), whereas there was a statistically significant difference between Group I and Group C in terms of leak volume and leak fraction ( p= 0.042 and p = 0.020, respectively ). Adverse events were similar among the groups (p > 0.05). DISCUSSION AND CONCLUSION: In this study, although the leak volume and leak fraction were lower in i-gel inserted patients, it was shown that i-gel, c-LMA and p-LMA provided adequate airway in elderly patients who were not applied muscle relaxants and will be operated under general anesthesia.

Bi-national survey of intraoperative cuff pressure monitoring of endotracheal tubes and supraglottic airway devices in operating theatres

Anaesthesia and Intensive Care ◽

10.1177/0310057x19850581 ◽

2019 ◽

Vol 47 (4) ◽

pp. 378-384 ◽

Cited By ~ 1

Author(s):

Julie Lee ◽

Heather Reynolds ◽

Anita M Pelecanos ◽

André AJ van Zundert

Keyword(s):

New Zealand ◽

Cuff Pressure ◽

Public Hospitals ◽

Supraglottic Airway ◽

Intracuff Pressure ◽

Pressure Monitoring ◽

Endotracheal Tubes ◽

Zealand College ◽

Correct intracuff pressure of endotracheal tubes and supraglottic airway devices is required to avoid complications such as sore throat, dysphagia and dysphonia, while maintaining an adequate airway seal. However, intracuff pressure monitoring of airway devices during general anaesthesia may not receive the attention it deserves. The aim of this survey was to investigate the current practice regarding intraoperative cuff pressure monitoring in hospitals across Australia and New Zealand. An online ten-question survey was disseminated by the Australian and New Zealand College of Anaesthetists Clinical Trials Network to a randomised selection of 1000 Australian and New Zealand College of Anaesthetists Fellows working in private and public hospitals of varying sizes. There were 305 respondents in total, but not all respondents answered all questions. In total, 67 of 304 respondents (22.0%) did not have access to a cuff pressure manometer at their main site of work, and of these, 30 (9.9%) expressed that they would like access to one in their daily practice. Of 288 respondents, 122 (40.0%) reported that they used cuff pressure monitoring as part of their routine practice, but 95 (33.0%) measured the cuff pressure at induction only. For supraglottic airway devices, only 44 of 250 respondents (17.6%) aimed for a cuff pressure of 40–60 cmH2O. Of 255 respondents, 101 (39.6%) aimed for a cuff pressure of 20–30 cmH2O for endotracheal tubes. These findings indicate that educational programmes are required to increase the availability and use of cuff pressure monitoring devices for both endotracheal tubes and supraglottic airway devices across Australia and New Zealand.