scholarly journals Blind Intubation through Self-pressurized, Disposable Supraglottic Airway Laryngeal Intubation Masks

2017 ◽  
Vol 127 (2) ◽  
pp. 307-316 ◽  
Author(s):  
Kurt Ruetzler ◽  
Sandra Esther Guzzella ◽  
David Werner Tscholl ◽  
Tanja Restin ◽  
Marco Cribari ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Muscle Relaxation ◽  
Intensive Therapy ◽  
Airway Device ◽  
University Hospital ◽  
Supraglottic Airway ◽  
Leak Pressure ◽  
Supraglottic Airway Device ◽  
Air Leak ◽  
Supraglottic Airway Devices

Abstract Background Supraglottic airway devices commonly are used for securing the airway during general anesthesia. Occasionally, intubation with an endotracheal tube through a supraglottic airway is indicated. Reported success rates for blind intubation range from 15 to 97%. The authors thus investigated as their primary outcome the fraction of patients who could be intubated blindly with an Air-Qsp supraglottic airway device (Mercury Medical, USA). Second, the authors investigated the influence of muscle relaxation on air leakage pressure, predictors for failed blind intubation, and associated complications of using the supraglottic airway device. Methods The authors enrolled 1,000 adults having elective surgery with endotracheal intubation. After routine induction of general anesthesia, a supraglottic airway device was inserted and patients were ventilated intermittently. Air leak pressure was measured before and after full muscle relaxation. Up to two blind intubation attempts were performed. Results The supraglottic airway provided adequate ventilation and oxygenation in 99% of cases. Blind intubation succeeded in 78% of all patients (95% CI, 75 to 81%). However, the success rate was inconsistent among the three centers (P < 0.001): 80% (95% CI, 75 to 85%) at the Institute of Anesthesia and Pain Therapy, Kantonsspital Winterthur, Winterthur, Switzerland; 41% (95% CI, 29 to 53%) at the Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, Lodz, Poland; and 84% (95% CI, 80 to 88%) at the Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland. Leak pressure before relaxation correlated reasonably well with air leak pressure after relaxation. Conclusions The supraglottic airway device reliably provided a good airway and allowed blind intubation in nearly 80% of patients. It is thus a reasonable initial approach to airway control. Muscle relaxation can be used safely when unparalyzed leak pressure is adequate.

scholarly journals The evaluation of the insertion parameters and complications of the i-gel Plus airway device for maintaining patent airway during planned procedures under general anaesthesia: a protocol for a prospective multi-center cohort study.

2021 ◽  
Author(s):  
Pavel Michalek ◽  
Olga Klementova ◽  
Taranpreet Kaur Bhoday ◽  
Jakub Werner ◽  
Ana Lopez ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Complications ◽  
Success Rate ◽  
General Anaesthesia ◽  
Airway Device ◽  
University Hospital ◽  
Supraglottic Airway ◽  
Military Hospital ◽  
Supraglottic Airway Device ◽  
Supraglottic Airway Devices

Introduction: Supraglottic airway devices represent a less invasive method of airway management than tracheal intubation during general anaesthesia. Their continued development is focused mainly on improvements in the insertion success rate and minimalization of perioperative and postoperative complications. The i-gel Plus is a novel, anatomically preshaped supraglottic airway device which achieves a perilaryngeal seal due to a non-inflatable cuff made of a soft thermoplastic elastomer. The purpose of this trial is to assess the success rate of the i-gel Plus use during elective procedures under general anaesthesia, its intraoperative performance, and the degree of postoperative complications. Methods and analysis: This is a multicenter, prospective, interventional cohort study. The enrolment will take place in seven centers in four European countries. We plan to enrol 2000 adult patients in total, who are scheduled for elective surgery under general anaesthesia, and with an indication for use of a supraglottic airway device for management of their airway. The study is projected to run over a period of 18 months. The primary outcome of the study is the total success rate of the i-gel Plus insertion in terms of successful ventilation and oxygenation through the device. Secondary outcomes include perioperative parameters, such as insertion time, seal/leak pressures, number of insertion attempts, and postoperative adverse events and complications. Postoperative follow-up will be performed at 1 hour, 24 hours in all patients, and for selected patients at 3 and 6 months. Ethics and dissemination: The trial has received the following ethical approvals: General University Hospital Prague, University Hospital Olomouc, University Military Hospital Prague, University Hospital Barcelona, University Hospital Lodz, Antrim Area Hospital, Craigavon Area Hospital, Office for Research Ethics Committees Northern Ireland. The results will be published in peer-reviewed journals and presented at relevant anaesthesia conferences.

scholarly journals Evaluation of the insertion parameters and complications of the i-gel Plus airway device for maintaining patent airway during planned procedures under general anaesthesia: a protocol for a prospective multicentre cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053215
Author(s):  
Olga Klementova ◽  
Taranpreet Kaur Bhoday ◽  
Jakub Werner ◽  
Ana M Lopez ◽  
Will Donaldson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Complications ◽  
Success Rate ◽  
General Anaesthesia ◽  
Airway Device ◽  
University Hospital ◽  
Supraglottic Airway ◽  
Military Hospital ◽  
Supraglottic Airway Device ◽  
Supraglottic Airway Devices

IntroductionSupraglottic airway devices represent a less invasive method of airway management than tracheal intubation during general anaesthesia. Their continued development is focused mainly on improvements in the insertion success rate and minimalisation of perioperative and postoperative complications. The i-gel Plus is a novel, anatomically preshaped supraglottic airway device which achieves a perilaryngeal seal due to a non-inflatable cuff made of a soft thermoplastic elastomer. The purpose of this cohort study is to assess the success rate of the i-gel Plus use during elective procedures under general anaesthesia, its intraoperative performance, and the degree of postoperative complications.Methods and analysisThis is a multicentre, prospective, interventional cohort study. The enrolment will take place in seven centres in four European countries. We plan to enrol 2000 adult patients in total, who are scheduled for elective surgery under general anaesthesia, and with an indication for use of a supraglottic airway device for management of their airway. The study is projected to run over a period of 18 months. The primary outcome of the study is the total success rate of the i-gel Plus insertion in terms of successful ventilation and oxygenation through the device. Secondary outcomes include perioperative parameters, such as insertion time, seal/leak pressures, number of insertion attempts and postoperative adverse events and complications. Postoperative follow-up will be performed at 1 hour, 24 hours in all patients, and for selected patients at 3 and 6 months.Ethics and disseminationThe cohort study has received the following ethical approvals: General University Hospital Prague, University Hospital Olomouc, University Military Hospital Prague, University Hospital Barcelona, University Hospital Lodz, Antrim Area Hospital, Craigavon Area Hospital, Office for Research Ethics Committees Northern Ireland. The results will be published in peer-reviewed journals and presented at relevant anaesthesia conferences.Trial registration numberISRCTN86233693;Pre-results.

Massive Engorgement of a Hemangioma of the Tongue After General Anesthesia Using a Supraglottic Airway Device: A Case Report

2020 ◽  
Vol 14 (9) ◽  
pp. e01256 ◽  
Author(s):  
Sushan Gupta ◽  
Saratchandra Majety ◽  
Jeson R. Doctor ◽  
Jigeeshu V. Divatia
Keyword(s):  
Case Report ◽  
General Anesthesia ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Supraglottic Airway Device

Intubating Through Supraglottic Airway Devices: A Narrative Review

2021 ◽  
Vol 11 (3) ◽  
Author(s):  
Say Yang Ong ◽  
Vanessa Moll ◽  
Berthold Moser ◽  
Amit Prabhakar ◽  
Elyse M. Cornett ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Endotracheal Tube ◽  
Airway Device ◽  
Narrative Review ◽  
Supraglottic Airway ◽  
Successful Intubation ◽  
Success Rates ◽  
Supraglottic Airway Device ◽  
Supraglottic Airway Devices ◽  
Consistent Performance

Implication Statement: Despite the increasing popularity of video laryngoscopes, the supraglottic airway device (SAD) remains a critical airway rescue tool. The SAD provides a conduit for tracheal intubation in failed laryngoscopy. This article aims to help the operator: (1) select an intubating SAD with consistent performance; (2) inform the appropriate SAD-endotracheal tube pairings; and (3) explain various SAD and endotracheal tube maneuvers available to increase chances of successful intubation. Objectives: The first supraglottic airway device (SAD) was introduced more than thirty years ago. Since then, SADs have undergone multiple iterations and improvements. The SAD remains an airway rescue device for ventilation and an intubation conduit on difficult airway algorithms. Data Sources: Several SADs are specifically designed to facilitate tracheal intubation, i.e., “intubating SADs,” while most are “non-intubating SADs.” The two most commonly reported tracheal intubation methods via the SADs are the blind and visualized passage of the endotracheal tube (ETT) preloaded on a fiberoptic scope. Fiberoptic guided tracheal intubation (FOI) via an intubating SAD generally has higher success rates than blind intubations and is thus preferred. However, fiberscopes might not always be readily available, and anesthesiologists should be skilled to successfully intubate blindly through a SAD. Summery: This narrative review describes intubating SAD with consistent performance, appropriate SAD-ETT pairings, and various SAD and ETT maneuvers to increase successful intubation chances.

scholarly journals Comparative Efficacy of the Air-Q Intubating Laryngeal Airway during General Anesthesia in Pediatric Patients: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Eun Jin Ahn ◽  
Geun Joo Choi ◽  
Hyun Kang ◽  
Chong Wha Baek ◽  
Yong Hun Jung ◽  
...  
Keyword(s):  
Systematic Review ◽  
General Anesthesia ◽  
Pediatric Patients ◽  
Meta Analysis ◽  
Final Analysis ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Comparative Efficacy ◽  
Supraglottic Airway Devices ◽  
Airway Devices

Air-Q® (air-Q) is a supraglottic airway device which can be used as a guidance of intubation in pediatric as well as in adult patients. We evaluated the efficacy and safety of air-Q compared to other airway devices during general anesthesia in pediatric patients by conducting a systematic review and meta-analysis. A total of 10 studies including 789 patients were included in the final analysis. Compared with other supraglottic airway devices, air-Q showed no evidence for a difference in leakage pressure and insertion time. The ease of insertion was significantly lower than other supraglottic airway devices. The success rate of intubation was significantly lower than other airway devices. However, fiberoptic view was better through the air-Q than other supraglottic airway devices. Therefore, air-Q could be a safe substitute for other airway devices and may provide better fiberoptic bronchoscopic view.

scholarly journals Performance of Size 1 I-Gel Compared with Size 1 ProSeal Laryngeal Mask in Anesthetized Infants and Neonates

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Gulay Erdogan Kayhan ◽  
Zekine Begec ◽  
Mukadder Sanli ◽  
Ender Gedik ◽  
Mahmut Durmus
Keyword(s):  
Primary Outcome ◽  
Good Alternative ◽  
Airway Device ◽  
Insertion Time ◽  
Supraglottic Airway ◽  
Controlled Study ◽  
Leak Pressure ◽  
Supraglottic Airway Device ◽  
Secondary Outcomes

Purpose. The size 1 I-gel, recommended for small infants and neonates weighing 2–5 kg, has recently been released. There are no prospective studies available that assess the insertion conditions, sealing pressures, or ventilation quality of it. This study was designed to compare the performance of recently released size 1 I-gel with size 1 ProSeal LMA.Methods. Fifty infants and neonates, ASA I-II were included in this prospective, randomized, and controlled study. Patients were divided into two groups for placing I-gel or ProSeal LMA. The primary outcome was airway leak pressure, and secondary outcomes included insertion time, insertion success and conditions, initial airway quality, fiberoptic view of the larynx, and complications.Results. There were no significant differences in terms of airway leak pressure between the I-gel (27.44±5.67) and ProSeal LMA (23.52±8.15) (P=0.054). The insertion time for the I-gel was shorter (12.6±2.19 s) than for the ProSeal LMA (24.2±6.059 s) (P=0.0001). Insertion success and conditions were similar in groups. We encountered few complications.Conclusion. Our study demonstrates that the size 1 I-gel provided an effective and satisfactory airway as the size 1 ProSeal LMA. It may be a good alternative supraglottic airway device for use in small infants and neonates. This trial is registered with: ClinicalTrials.govNCT01704118.

scholarly journals Comparison of the Effects of Desflurane, Sevoflurane, and Propofol on the Glottic Opening Area during Remifentanil-Based General Anesthesia Using a Supraglottic Airway Device

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Takashi Kondo ◽  
Hiromichi Izumi ◽  
Makiko Kitagawa
Keyword(s):  
General Anesthesia ◽  
Video Recording ◽  
Peak Inspiratory Pressure ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Supraglottic Airway Device ◽  
Glottic Opening ◽  
Upper Limb Surgery ◽  
Plexus Block ◽  
Group D

Purpose. The aim of this study was to compare the effects of desflurane, sevoflurane, and propofol on the glottic opening area during general anesthesia using remifentanil. Methods. Ninety patients undergoing hand and upper limb surgery combined with brachial plexus block under general anesthesia were enrolled in the study. The patients were randomized into three groups to receive desflurane (group D), sevoflurane (group S), or propofol (group P) for maintenance of anesthesia. Following induction of general anesthesia with remifentanil, continuous fiberoptic video recording around the glottis via an i-gel™ supraglottic device was started after establishing mechanical ventilation. Desflurane, sevoflurane, or propofol was administrated after video recording was started. The changes in normalized glottic opening area (n-GOA) and peak inspiratory pressure (PIP) during surgery were compared between the three groups. Results. Intraoperative changes of n-GOA in group D showed significant differences compared with group S and group P (−0.0656 ± 0.0772 vs. −0.0076 ± 0.0499 and +0.0269 ± 0.0809, P=0.005 and P<0.0001). The changes of PIP in group D showed significant differences compared with group S and group P (+3.7 ± 3.4 cmH2O vs. +1.0 ± 1.3 cmH2O and −0.3 ± 3.6 cmH2O, P=0.002 and P<0.0001). Four cases of relapsed glottic stenosis in group D were improved by changing desflurane to propofol. Conclusions. Desflurane narrowed the n-GOA and increased the PIP compared to sevoflurane and propofol during general anesthesia with remifentanil. Clinicians should be aware of the possibility of glottic stenosis during desflurane-remifentanil anesthesia when the airway is secured by a supraglottic airway device without the use of neuromuscular blockade.

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