Pulmonary Airway Resistance with the Endotracheal Tube versus Laryngeal Mask Airway in Paralyzed Anesthetized Adult Patients 

1999 ◽  
Vol 90 (2) ◽  
pp. 395-397 ◽  
Author(s):  
Alison Berry ◽  
Joseph Brimacombe ◽  
Christian Keller ◽  
Chandi Verghese
Keyword(s):  
Laryngeal Mask Airway ◽  
Endotracheal Tube ◽  
Airway Pressure ◽  
Airway Resistance ◽  
Adult Patients ◽  
Laryngeal Mask ◽  
Peak Airway Pressure ◽  
Device Resistance ◽  
The Mean ◽  
Pulmonary Airway

Background The hypothesis that airway resistance is less with the laryngeal mask airway than with the endotracheal tube was tested. Methods Thirty-six paralyzed, anesthetized adult patients with no respiratory disease (American Society of Anesthesiologists physical status 1-3; age, 18-80 yr) were randomly allocated (9 men, 9 women in each group) to receive either a size-4 laryngeal mask airway or an endotracheal tube (men, 9-mm ID; women, 8-mm ID). A pulmonary monitor with flow transducer and esophageal balloon was used to measure peak airway pressure and mean airway resistance (device resistance plus pulmonary airway resistance) at three different tidal volumes (5, 10, and 15 ml/kg). Device resistance was measured in vitro with the distal end of the endotracheal tube or laryngeal mask airway open to the atmosphere and using the same ventilator settings. Pulmonary airway resistance was derived by subtracting the mean device resistance from the mean airway resistance. Results Peak airway pressure, mean airway resistance, device resistance, and pulmonary airway resistance were greater for the endotracheal tube (all P < 0.0001). Conclusions The laryngeal mask airway triggers less bronchoconstriction than does the endotracheal tube in paralyzed anesthetized adult patients. This may have implications for maintaining intraoperative pulmonary function and reducing the risk for atelectasis and pulmonary infection.

scholarly journals Comparison of ProSeal laryngeal mask airway, classical laryngeal mask airway with endotracheal tube in gynecological laparoscopy under controlled ventilation

2019 ◽  
Vol 6 (1) ◽  
pp. 81
Author(s):  
Anupkumar S. Patel ◽  
Namrata Jain
Keyword(s):  
Laryngeal Mask Airway ◽  
Endotracheal Tube ◽  
Sore Throat ◽  
Airway Pressure ◽  
Pulmonary Ventilation ◽  
Proseal Laryngeal Mask Airway ◽  
Laryngeal Mask ◽  
Peak Airway Pressure ◽  
Controlled Ventilation ◽  
Gynecological Laparoscopy

Background: PLMA is a recent, complex, and ingenious development with some added feature of classic LMA like modified dual cuff, drain tube, positive pressure ventilation at higher peak inspiratory pressure. Study was to evaluate and compare the use of classical laryngeal mask airway, ProSeal laryngeal mask airway, and endotracheal tube with controlled ventilation in patients undergoing gynecological laparoscopic procedure.Methods: About 150 patients, ASA risk I and II, posted for elective gynecological laparoscopy were recruited in the study. All the patients between 18 to 45years of age were randomly divided in three groups, group PLMA, group CLMA, group ETT (50 patients each). Attempt of insertion of airway device, leaks pressure, pulmonary ventilation, hemodynamic; heart and MAP, gastric distention was recorded. All patients were of middle age group, comparable in weight. Mean duration of laparoscopy was comparable in all the groups.Results: Significant rise in heart rate and mean arterial pressure seen in group ETT after induction of anesthesia. Changes in the end tidal CO2 and peak airway pressure after induction of anesthesia, before and after pneumoperitonium were comparable in all three groups. After head low position peak airway pressure is slightly raised in group PLMA, group CLMA. Gastric distension was noted higher in group 10 % as compare to group PLMA (8%) and group (2%). Incidence of sore throat (22%), nausea vomiting (14%) and airway trauma (14%) was higher in group ETT.Conclusions: Hemodynamic stability was better in and CLMA group at time of induction and comparable in all three groups at time of pneumoperitoneum and trendelenburg position along with pulmonary ventilation. Post-operative sore throat, nausea vomiting was higher with endotracheal tube.

Comparison of Proseal Laryngeal Mask Airway Versus Endotracheal Tube in Anaesthetized Adult Patients

2018 ◽  
Vol 5 (3) ◽  
pp. 415-418
Author(s):  
Saranjit Singh ◽  
◽  
Sapna Bansal ◽  
Rahul Midda ◽  
Dhanwant Kaur ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Endotracheal Tube ◽  
Proseal Laryngeal Mask Airway ◽  
Adult Patients ◽  
Laryngeal Mask

A Randomized Crossover Comparison of Airway Sealing with the Laryngeal Mask Airway Ambu AuraFlex at Three Intracuff Pressures in Pediatric Laparoscopic Surgery

2019 ◽  
Author(s):  
Xiang Liu ◽  
Xiaona Tan ◽  
Qi Zhang ◽  
Li Qiao ◽  
Lei Shi
Keyword(s):  
Laparoscopic Surgery ◽  
Laryngeal Mask Airway ◽  
Airway Pressure ◽  
Laryngeal Mask ◽  
Peak Airway Pressure ◽  
Supraglottic Airway ◽  
Intracuff Pressure ◽  
Leak Pressure ◽  
Oropharyngeal Leak Pressure ◽  
Mucosal Change

Abstract Objective An adequate intracuff pressure is important to ensure sufficient sealing function when using supraglottic airway devices to protect the airway from secretions and achieve adequate positive pressure ventilation. The aim of this study is to analyze a feasible and effective alternative Ambu AuraFlex intracuff pressure in child's laparoscopic surgery. Study Design Seventy-two children were included in this study. After insertion of the laryngeal mask airway AuraFlex, oropharyngeal leak pressure (OLP) was measured at intracuff pressures of 10, 30, and 60-cmH2O according to one of six sequences produced on the basis of 3 × 6 Williams crossover design. During the intraoperative period, AuraFlex was maintained using the last intracuff pressure of the allocated sequence. Oropharyngeal leak pressure, peak airway pressure, the fiberoptic view, mucosal change, and complications were assessed at three intracuff pressures. Results The OLP at the intracuff pressure of 10 cmH2O was significantly lower than that of 30 cmH2O (2# 18.1 ± 1.5 vs. 19.5 ± 1.4 cmH2O, p = 0.001; 2.5# 17.7 ± 1.2 vs. 20.2 ± 1.4, p = 0.001) and 60 cmH2O (2# 18.1 ± 1.5 vs. 20.0 ± 1.3 cmH2O, p = 0.002; 2.5# 17.7 ± 1.2 vs. 20.8 ± 1.1, p = 0.003). Compared with the peak airway pressure in pre-and postpneumoperitoneum, the OLP was significantly higher. Subgroup analysis showed no differences in mucosal change and complications. Conclusion Intracuff pressures of 30 may be sufficient for the Ambu AuraFlex in child's laparoscopic surgery, and there may be no added benefit of an intracuff pressure of 60 cmH2O, as oropharyngeal leak pressures were similar.

scholarly journals Comparison of the Skill of Emergency Medical Technicians in Terms of Advanced Airway Management Using Endotracheal Tube vs Laryngeal Mask Airway in an OSCE Using a Mannequin

2020 ◽  
Author(s):  
Peyman Saberian ◽  
Ehsan Karimialavijeh ◽  
Mostafa Sadeghi ◽  
Mojgan Rahimi ◽  
Parisa Hasani-Sharamin ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Emergency Medical ◽  
Advanced Airway ◽  
Significant Difference ◽  
The Mean

Background: Supraglottic airway management tools such as the laryngeal mask airway (LMA) have recently emerged as the first choice in pre-hospital and hospital airway management guidelines as well as an alternative strategy after endotracheal tube (ETT) placement failure. However, the pros and cons of the LMA compared to endotracheal intubation are still debated. Given that no study has been conducted to date on the skills of emergency medical technician (EMT) in airway management using LMA compared to endotracheal intubation, we decided to do a study in this regard. Methods: In this objective structured clinical examination (OSCE), EMTs who had a degree of associate or bachelor were participated. The examiner asked the examinees the required information and entered it in the pre-prepared checklists. The participants took part in a two-stage exam. In the first stage, the airway management of the simulated trauma patient was performed by endotracheal intubation, and in the second stage, the same scenario was performed with LMA. At each stage, the examiner evaluated the examinee's performance in 4 fields of Preparation, Pre-oxygenation, Position and Placement, and Post-intubation management using a standard checklist. In addition, the duration of the procedure from the beginning to the time of fixing the ETT or LMA was recorded and compared. Results: Totally, 105 EMTs participated in this study, of whom, 102 were male (97.1%). The mean age of the subjects was 36.4± 7.3 years old. Of the total participants, 72 passed both practical exams successfully, and they generally insert the LMA faster; so that the duration of intubation and LMA insertion in 1.4% and 30.6% were <1 min, respectively (p< 0.001). However, no significant difference was observed in terms of the mean time (p= 0.427). Conclusion: In the present study, the skills of the technicians participating in the study in performing advanced airway procedures were moderate, and also, it was found that their skills in LMA insertion were less than endotracheal tube insertion.

Flexible Laryngeal Mask Airway for Cleft Palate Surgery in Children: A Randomized Clinical Trial on Efficacy and Safety

2009 ◽  
Vol 46 (4) ◽  
pp. 368-373 ◽  
Author(s):  
Pankaj Kundra ◽  
N. Supraja ◽  
K. Agrawal ◽  
M. Ravishankar
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Pressure ◽  
Postgraduate Medical Education ◽  
Lung Compliance ◽  
Laryngeal Mask ◽  
Peak Airway Pressure ◽  
Original Position ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Parametric Data

Objective: To evaluate the efficacy of a flexible laryngeal mask airway in children undergoing palatoplasty. Design: Prospective, randomized, single-center study. Setting: Jawaharlal Institute of Postgraduate Medical Education and Research. Patients: Sixty-six children (American Society of Anesthesiologists physical status 1 and 2) scheduled to undergo palatoplasty were assigned randomly to an endotracheal intubation group (RAE group, n  =  33) and a flexible laryngeal mask airway group (FLMA group, n  =  33). Main Outcome Measures: Peak airway pressure, inspired and expired tidal volume, end-tidal carbon dioxide, lung compliance, and airway resistance were continuously measured after placement of the assigned airway. The percentage leak around the airway was quantified as the leak fraction. Parametric data between groups were analyzed using an unpaired Student's t test and within groups using a one-way analysis of variance. Nonparametric variables were analyzed using the Fisher exact test. Results: In two children, the flexible laryngeal mask airway was displaced from its original position; whereas, one endotrachial tube advanced endobronchially. The leak fraction was significantly higher in the RAE group when compared with that in FLMA group (13.34% ± 13.74% versus 5.96% ± 3.78%, p < .05) until the throat pack was applied. Peak airway pressure and resistance were significantly higher in the RAE group compared with the FLMA group at all time intervals, p < .05. During emergence, frequency of coughing, desaturation, and laryngospasm were increased in the RAE group. Conclusion: A flexible laryngeal airway mask is suitable for maintaining the airway and helps in smooth emergence in children undergoing palatoplasty.

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