scholarly journals A Comparison between the i-gel® and air-Q® Supraglottic Airway Devices Used for the Patients Undergoing General Anesthesia with Muscle Relaxation

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Nilofar Massoudi ◽  
Mohammad Fathi ◽  
Navid Nooraei ◽  
Alireza Salehi
Keyword(s):  
General Anesthesia ◽  
Sore Throat ◽  
Muscle Relaxation ◽  
Insertion Time ◽  
Supraglottic Airway ◽  
Positive Pressure ◽  
Double Blind ◽  
Supraglottic Airway Devices ◽  
Duration Of Surgery ◽  
The Mean

Objectives. The aim of the present study was to compare two supraglottic airway (SGA) devices (i.e., the i-gel® © Intersurgical Ltd and air-Q® (Reusable) Cookgas company) in terms of the insertion time, amount of leak during ventilation with maximum positive pressure, and postoperative complications in patients referring to Modarres Hospital in Tehran.Method.The present double-blind clinical trial was performed on 60 patients undergoing elective surgeries that required general anesthesia with muscle relaxation. Patients were randomly assigned to either i-gel® (n= 30) or Air-Q® (n= 30) groups.Results.The mean age, body mass index, duration of surgery, duration of anesthesia, and gender ratio were not significantly different between the two groups. Mean ± SD values of the SGA devices’ insertion time (in seconds) in the air-Q® and i-gel® groups were 4.87 ± 1.6 and 6.80 ± 1.2, respectively (P < 0.001). The mean OLP in the Air-Q® group was significantly higher than that of the i-gel® group (35.9 ± 9.6 versus 24.8 ± 3.7, p < 0.001). The frequency of complications occurred after the supraglottic airway insertion was higher in the i-gel® group. However, only in terms of sore throat, the difference between the two groups was statistically significant: 6 (20%) had sore throat (P = 0.024) in the i-gel groups, but in in the Air-Q® groups no one had this side effect after surgery.Conclusion.It was concluded that the Air-Q® supraglottic airway was placed faster and easier with fewer complications than the i-gel in general anesthesia with muscle relaxation. The frequency of the occurrence of all three complications, cough, sore throat, and blood, on the cuff (6 (20%) was higher in the i-gel group than that in the air-Q® group (cough3 (10%), sore throat 0 (0%), and blood on the cuff 3 (10%) (P < 0.05).

A COMPARISON OF EFFECT OF NEBULISED KETAMINE AND NEBULISED MAGNESIUM SULPHATE IN REDUCTION OF INCIDENCE AND SEVERITY OF POSTOPERATIVE SORE THROAT - A PROSPECTIVE RANDOMIZED DOUBLE BLINDED STUDY

2021 ◽  
pp. 38-40
Author(s):  
M. Selvi Annie Geeta ◽  
M. Ramesh Ram
Keyword(s):  
Tracheal Intubation ◽  
General Anesthesia ◽  
Sore Throat ◽  
Magnesium Sulphate ◽  
Success Rates ◽  
Postoperative Sore Throat ◽  
It Effectiveness ◽  
Duration Of Surgery ◽  
The Mean ◽  
Group B

Introduction: Postoperative sore throat (POST) is a common occurrence following general anesthesia with endotracheal intubation. The incidence of POST is estimated to be 21%-65% in various studies. Irritation and inammation of the air way are considered to be the cause of POST. Although considered a minor and self limiting complication, it may cause a signicant patient morbidity, dissatisfaction and increased the length of duration of hospital stay. Various pharmacological and non pharmacological methods have been tried to decrease POST with varying success rates. Among the interventions, the use of ketamine gargle or lozenges has highest success rates, but the problem with this is the bitter taste of the drug and the risk of aspiration, so aerosol route of drug administration gained popularity among the anesthesiologists with good acceptance from the patients. It is known that N-methyl-D-aspartate (NMDA) receptors have a role in nociception and inammation. Hence, this study is aimed at using the aerosol route of magnesium sulphate and ketamine and to nd it effectiveness in preventing POST. Aim Of The Study: To evaluate the effect of nebulized ketamine and nebulized magnesium sulphate for attenuation of postoperative sore throat in patients undergoing surgeries under general anesthesia with tracheal intubation. Materials And Methods: This study was done in the Department of Anesthesiology in collaboration with the Department of Surgery in Kanyakumari Government Medical College from January 2019 to December 2019. Patient planned for surgery under general anesthesia except head, neck & ENT surgeries were selected and randomized into two groups (35 each). Each group received nebulisation for 15 min before induction of general anaesthesia. Group M: Nebulization with 500mg magnesium sulphate in 5ml NS. Group K: Nebulization with 50mg ketamine in 5ml NS. The Parameters related to the study such as duration of laryngoscopy, time taken to intubate, duration of surgery, number of attempts to intubate were recorded. Incidence and severity of sore throat were assessed by four point scale. Incidence of sore throat is assessed for 24 hours. Complication were recorded. Results: We found that the demographic parameters were comparable and statistically insignicant. The mean duration of laryngoscopy difference between the two groups Group M - 24.54± 1.12 seconds and Group K - 24.49 ±1.15 seconds was not statistically signicant P= 0.834 (P>0.05). The mean time taken to intubate in Group M - 27.54± 1.12 seconds and Group K - 27.54± 1.12 seconds was not statistically signicant with P=1.000 respectively (P>0.05). The mean duration of surgery in Group M - 90.71±15.67 minutes and the Group K - 88.20 ±16.53 minutes between the two groups was not statistically signicant P= 0.516 (P>0.05). The mean difference of number of attempts taken to intubate between the two groups was statistically insignicant P=0.771 (P>0.05). The overall incidence of sore throat in Group M was 91% and in Group B was 34%. The severity of sore throat between Group M and Group K is statistically signicant at 2, 4, 6 hrs at grade 1 and grade 2. Conclusion: On the basis of our result, we can suggest that the use of perioperative ketamine nebulization when compared magnesium sulphate nebulization reduces the incidence and severity of post-operative sore throat at 4th and 6th hour during postoperative period in patients who had received general anesthesia with tracheal intubation.

scholarly journals A comparison of two supraglottic airway devices in general anaesthesia: baska mask® vs. I-gel®

2019 ◽  
Vol 6 (12) ◽  
pp. 333-339
Author(s):  
Özlem Sezen
Keyword(s):  
General Anaesthesia ◽  
Sore Throat ◽  
Clinical Performance ◽  
Insertion Time ◽  
Supraglottic Airway ◽  
Peripheral Oxygen Saturation ◽  
Supraglottic Airway Devices ◽  
Gastric Regurgitation ◽  
Significant Difference ◽  
Airway Devices

Objective: The aim of this was to compare the Baska® mask and the I-gel® airway in paralyzed patients during general anaesthesia in terms of clinical performance, the risk of aspiration, and intraoperative and postoperative characteristics. Material and Methods: The two devices were compared in 100 paralyzed anesthetized adult patients. Primary outcomes of the study were to evaluate the characteristics of the airway devices within respect to the success of first insertion attempt, the insertion time, the ease of insertion, leak volume, and peak airway pressure. The blood staining on the mask, and the presence of gastric reflux or sore throat two hours postoperatively were evaluated. Hemodynamics, end-tidal CO2 and the peripheral oxygen saturation measurements were secondary outcomes. Results: No statistically significant difference was observed between the groups in the criteria of first attempt success rate, ease of insertion, blood staining upon removal of the masks, gastric regurgitation, or sore throat two hours after the procedure. The insertion time was significantly longer for the Baska® mask compared with the I-gel® airway. The leak volume was significantly higher in the Baska® mask patients throughout the surgical procedure. The heart rate and mean arterial pressure measurements were significantly higher in the Baska® mask patients. Conclusions: Both the Baska® mask and the I-gel ® device can be used effectively for selected paralyzed patients under general anaesthesia. The insertion time was significantly longer for the Baska® mask compared with the I-gel® device.

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 &lt; 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.

To compare the frequency of postoperative sore throat with I-gel versus laryngeal mask airway in patients

2021 ◽  
Vol 15 (12) ◽  
pp. 3232-3235
Author(s):  
M. J. Ahmed Kamal ◽  
Baber Zaheer ◽  
Naveed Ahmed Durrani ◽  
Khaleel Ahmad ◽  
Sumara Tabassam ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
General Anesthesia ◽  
Sore Throat ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Postoperative Sore Throat ◽  
Significant Difference ◽  
Group A ◽  
Group Members ◽  
Group B

Background: In case of general anesthesia, airway maintenance along with least complications is the most important goal of team of anesthesiologists. In case of clinical practice, the laryngeal mask airway (LMA) devices have superiority in managing supraglottic airway. Recently i-gel airway has been introduced as supraglottic airway equipment (disposable). Aim: To make comparison between laryngeal mask and I-gel with respect to postoperative complication of sore throat in case of patients who were given general anesthesia. Study design: Randomized trial Setting: Anesthesia Department Study duration: 6 after synopsis approval in total 6months of duration Methods: Candidates were divided randomly divided into two groups. In case of members of group A, patients were given i-gel where as members of group B, disposable LMA was given. General anesthesia was administered according to the standardized protocols. A day after operation, candidates were check post operatively for 24 hours, for sore throat and information was documented on Performa. Results: The candidates mean age was 44.23±15.11years in case of i-gel group members whereas 46.10±15.56 years in case of LMA group. In case of i-gel group, there were about twenty five males members and thirty five were females members . In case of LMA group members, there were about twenty six males and thirty four female members . In present case research, sore throat postoperatively was seen in case of 17(14.2%) cases, i.e. 4 (6.7%) in i-gel group while 13(21.7%) in case of LMA group. The significant difference was witnessed between members of both groups (p<0.05). Conclusion: Thus i-gel is better than LMA for general anesthesia as it has fewer chances of side effects like postoperative sore throat. Keywords: Postoperative sore throat, I-gel, laryngeal mask airway, general anesthesia

scholarly journals Comparison of intra-gastric pressure between endotracheal tube and supraglottic airway devices in laparoscopic hepatectomy:A randomised, controlled, non-inferiority study

2020 ◽  
Author(s):  
Jin Hee Ahn ◽  
Jiseon Jeong ◽  
Se Hee Kang ◽  
Ji Eun Yeon ◽  
Eun A Cho ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Sore Throat ◽  
Second Generation ◽  
Laparoscopic Hepatectomy ◽  
Operation Time ◽  
Drainage Tube ◽  
Supraglottic Airway ◽  
Clinical Trial Registration ◽  
Gastric Pressure ◽  
Supraglottic Airway Devices

Abstract Background Supraglottic airway (SGA) devices do not definitively protect the airway from regurgitation of gastric contents. Increased gastric pressure and long operation time are associated with development of complications such as aspiration pneumonia. The aim of this study was to compare intra-gastric pressure between second-generation SGA and endotracheal tube (ETT) devices during long-duration laparoscopic hepatectomy.Methods A total of 66 patients was randomly assigned to two groups; 33 patients each in the ETT and SGA groups. Intra-gastric pressure was continuously measured via a gastric drainage tube with a three-way stopcock connected to the pressure monitoring device. Normal saline was added to the end of the gastric drainage tube at each operation time point.Results Intra-gastric pressure during pneumoperitoneum was no different between the two groups (p = 0.146) or over time (p = 0.094). The mean (SD) pH of the SGA tip measured after operation was 6.7 (0.4), and a pH less than 4 was not observed. Relative risk of postoperative complications was significantly higher in the ETT group relative to the SGA group (sore throat, 5.5; cough,13.0).Conclusions Use of SGA devices does not further increase intra-gastric pressure, even during prolonged upper abdominal laparoscopic surgery. Also, the frequency of postoperative sore throat and cough was significantly lower when the second-generation SGA device was used.Clinical trial registration of Korea (https://cris.nih.go.kr/cris/index.jsp): KCT0003512 Principle investigator: G S K; date of registration February 15, 2019, https://cris.nih.go.kr/cris).

Sore throat following three adult supraglottic airway devices

2017 ◽  
Vol 34 (7) ◽  
pp. 417-424 ◽  
Author(s):  
Joël L’Hermite ◽  
Elisabeth Dubout ◽  
Sophie Bouvet ◽  
Laure-Hélène Bracoud ◽  
Philippe Cuvillon ◽  
...  
Keyword(s):  
Sore Throat ◽  
Supraglottic Airway ◽  
Supraglottic Airway Devices ◽  
Airway Devices

scholarly journals A Randomised Controlled Trial Comparing Fibreoptic-Guided Tracheal Intubation through Two Supraglottic Devices: Ambu® Auragain™ Laryngeal Mask and LMA® Fastrach™

2018 ◽  
Vol 46 (5) ◽  
pp. 474-479 ◽  
Author(s):  
G. Preece ◽  
I. Ng ◽  
K. Lee ◽  
P. Mezzavia ◽  
R. Krieser ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Endotracheal Intubation ◽  
Controlled Trial ◽  
Muscle Relaxation ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Supraglottic Airway Devices ◽  
Airway Pathology ◽  
Airway Devices ◽  
Randomised Controlled

The Ambu®AuraGain™ laryngeal mask (LM) (Ambu A/S, Ballerup, Denmark) is one of the few readily available second-generation supraglottic airway devices (SADs) that offer a conduit for fibreoptic-guided endotracheal intubation. We aimed to compare fibreoptic intubation through this device with the LMA® (laryngeal mask airway) Fastrach™ (Teleflex Medical, Co. Westmeath, Ireland), which has been a recommended dedicated rescue device for the management of the unanticipated difficult airway. This randomised controlled trial compared a previously described fibreoptic score in 116 patients with no known airway pathology, who had asleep fibreoptic endotracheal intubation via either the AuraGain LM or the LMA Fastrach. Time, ease and success rate of SAD and endotracheal tube (ETT) insertion and complications were recorded. The AuraGain LM demonstrated better laryngeal alignment with 29 out of 59 patients in the AuraGain LM (AG) group having a Grade 4 view (only vocal cords visible), compared to 20 out of 54 patients in the LMA Fastrach (FT) group (P=0.003). It allowed significantly quicker and easier ETT intubation when used as a conduit. The AuraGain LM was also quicker to insert compared to the Fastrach LMA. Similar rates of minor complications, such as sore throat and dysphonia occurred in both groups. Our study indicates that when used in patients with complete muscle relaxation and no known airway pathology, the AuraGain LM achieves better laryngeal alignment and quicker, easier and more successful fibreoptic-guided ETT intubation than the Fastrach LMA.

Uterine Isthmus Tourniquet during Abdominal Myomectomy: Support or Hazard? A Randomized Double-Blind Trial

2020 ◽  
Vol 85 (5) ◽  
pp. 396-404
Author(s):  
Abolfazl Mehdizadehkashi ◽  
Kobra Tahermanesh ◽  
Samaneh Rokhgireh ◽  
Vahideh Astaraei ◽  
Zahra Najmi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Ovarian Reserve ◽  
Operating Time ◽  
Serum Levels ◽  
Massive Hemorrhage ◽  
Control Group ◽  
Double Blind ◽  
Abdominal Myomectomy ◽  
Duration Of Surgery ◽  
The Mean

<b><i>Background and Objectives:</i></b> A tourniquet has been suggested as a useful means of reducing massive hemorrhage during myomectomy. However, it is not clear whether the restricted perfusion affects the ovaries. In the present study, we examined the effect of a tourniquet on ovarian reserve and blood loss during myomectomy. <b><i>Materials and Methods:</i></b> In a randomized double-blind clinical trial, fertile nonobese patients scheduled for abdominal myomectomy at Rasool-e-Akram Hospital from February 2018 to June 2019 were randomized to a tourniquet (<i>n</i> = 46) or a non-tourniquet group (<i>n</i> = 35). Serum levels of anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) were measured before and 3 months after surgery, blood loss was recorded during surgery, and serum levels of hemoglobin (Hb) were recorded before surgery, 6 h and 3 days after surgery. SPSS version 21 was used for statistical analysis. <b><i>Results:</i></b> Demographic, obstetric, and myoma characteristics were similar in the 2 groups (<i>p</i> &#x3e; 0.05). The mean baseline values of AMH and FSH did not differ between groups (<i>p</i> &#x3e; 0.05). After surgery, only FSH was higher in the control group (<i>p</i> = 0.043). Despite the time taken to fasten and open the tourniquet, the mean operating time was shorter in the tourniquet group (<i>p</i> &#x3c; 0.001). Blood loss was higher in the control group (<i>p</i> = 0.005). The drop in Hb levels at 6 h after surgery was higher in the non-tourniquet group (<i>p</i> = 0.002). Blood loss was significantly associated with the duration of surgery (<i>r</i> = 0.523, <i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> The use of a tourniquet during abdominal myomectomy significantly reduced the mean volume of blood loss compared to the non-tourniquet group, while it did not prolong the duration of surgery, nor reduced the ovarian reserve. A tourniquet is a safe and efficient measure during abdominal myomectomy.

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

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 ◽  
Supraglottic Airway Devices ◽  
Significant Difference ◽  
Airway Devices

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.

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