Comparison of the Intubating Laryngeal Mask Airway with the Fiberoptic Intubation in Anticipated Difficult Airway Management

2003 ◽  
Vol 47 (2) ◽  
pp. 66
Author(s):  
&NA;
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Difficult Airway ◽  
Laryngeal Mask ◽  
Fiberoptic Intubation ◽  
Difficult Airway Management ◽  
Intubating Laryngeal Mask Airway

Comparison of the Intubating Laryngeal Mask Airway with the Fiberoptic Intubation in Anticipated Difficult Airway Management

2001 ◽  
Vol 94 (6) ◽  
pp. 968-972 ◽  
Author(s):  
Olivier Langeron ◽  
François Semjen ◽  
Jean-Louis Bourgain ◽  
Alain Marsac ◽  
Anne-Marie Cros
Keyword(s):  
Laryngeal Mask Airway ◽  
Tracheal Intubation ◽  
Adverse Events ◽  
Oxygen Saturation ◽  
Difficult Airway ◽  
Difficult Intubation ◽  
Laryngeal Mask ◽  
Fiberoptic Intubation ◽  
Alternative Technique ◽  
Intubating Laryngeal Mask Airway

Background The intubating laryngeal mask airway (ILMA; Fastrach; Laryngeal Mask Company, Henley-on-Thames, UK) may provide an alternative technique to fiberoptic intubation (FIB) to facilitate the management of the anticipated difficult airway. The authors therefore compared the effectiveness of the ILMA with FIB in patients with anticipated difficult intubation. Methods One hundred patients, with at least one difficult intubation criteria (Mallampati class III or IV, thyromental distance < 65 mm, interincisor distance < 35 mm) were enrolled (FIB group, n = 49; ILMA group, n = 51) in this prospective randomized study. Anesthesia was induced with propofol and maintained with alfentanil and propofol after an efficient mask ventilation has been demonstrated. The success of the technique (within three attempts), the number of attempts, duration of the successful attempt, and adverse events (oxygen saturation < 90%, bleeding) were recorded. Results The rate of successful tracheal intubation with ILMA was 94% and comparable with FIB (92%). The number of attempts and the time to succeed were not significantly different between groups. In case of failure of the first technique, the alternative technique always succeeded. Failures in FIB group were related to oxygen desaturation (oxygen saturation < 90%) and bleeding, and to previous cervical radiotherapy in the ILMA group. Adverse events occurred significantly more frequently in FIB group than in ILMA group (18 vs. 0%, P < 0.05). Conclusion The authors obtained a high success rate and comparable duration of tracheal intubation with ILMA and FIB techniques. In patients with previous cervical radiotherapy, the use of ILMA cannot be recommended. Nevertheless, the use of the ILMA was associated with fewer adverse events.

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 Pediatric Trainees Managing a Difficult Airway: Comparison of Laryngeal Mask Airway, Direct, and Video-Assisted Laryngoscopy

OTO Open ◽  
2017 ◽  
Vol 1 (2) ◽  
pp. 2473974X1770791 ◽  
Author(s):  
Art Ambrosio ◽  
Kastley Marvin ◽  
Colleen Perez ◽  
Chelsie Byrnes ◽  
Cory Gaconnet ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Difficult Airway ◽  
Direct Laryngoscopy ◽  
Training Session ◽  
Laryngeal Mask ◽  
Normal Infant ◽  
Difficult Airway Management ◽  
Video Assisted ◽  
Advanced Airway

Objective Difficult airway management is a key skill required by all pediatric physicians, yet training on multiple modalities is lacking. The objective of this study was to compare the rate of, and time to, successful advanced infant airway placement with direct laryngoscopy, video-assisted laryngoscopy, and laryngeal mask airway (LMA) in a difficult airway simulator. This study is the first to compare the success with 3 methods for difficult airway management among pediatric trainees. Study Design Randomized crossover pilot study. Setting Tertiary academic medical center. Methods Twenty-two pediatric residents, interns, and medical students were tested. Participants were provided 1 training session by faculty using a normal infant manikin. Subjects then performed all 3 of the aforementioned advanced airway modalities in a randomized order on a difficult airway model of a Robin sequence. Success was defined as confirmed endotracheal intubation or correct LMA placement by the testing instructor in ≤120 seconds. Results Direct laryngoscopy demonstrated a significantly higher placement success rate (77.3%) than video-assisted laryngoscopy (36.4%, P = .0117) and LMA (31.8%, P = .0039). Video-assisted laryngoscopy required a significantly longer amount of time during successful intubations (84.8 seconds; 95% CI, 59.4-110.1) versus direct laryngoscopy (44.9 seconds; 95% CI, 33.8-55.9) and LMA placement (36.6 seconds; 95% CI, 24.7-48.4). Conclusions Pediatric trainees demonstrated significantly higher success using direct laryngoscopy in a difficult airway simulator model. However, given the potential lifesaving implications of advanced airway adjuncts, including video-assisted laryngoscopy and LMA placement, more extensive training on adjunctive airway management techniques may be useful for trainees.

scholarly journals Laryngeal Mask Airway for Pediatric/Difficult Airway Management

2011 ◽  
Vol 31 (7) ◽  
pp. 923-930
Author(s):  
Tetsuro KAGAWA ◽  
Aya YAMAMOTO ◽  
Akitsu MURAKAMI ◽  
Takeshi SUZUKI ◽  
Noriyuki IKEJIMA
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Difficult Airway ◽  
Laryngeal Mask ◽  
Difficult Airway Management
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