A comparison of laryngeal mask airway-supreme and endotracheal tube use with respect to airway protection in patients undergoing septoplasty: a randomized, single-blind, controlled clinical trial

Abstract Background There are doubts among anesthesiologists on the use of the Laryngeal Mask Airway (LMA) in nasal surgeries because of concerns about the occurrence of blood leakages to the airway. We hypothesized that the use of LMA-Supreme (LMA-S) in nasal surgery is comparable with endotracheal tube (ETT) according to airway protection against blood leakage through the fiberoptic bronchoscopy, oropharyngeal leakage pressure (OLP), heart rate (HR), mean arterial pressure (MAP), and postoperative adverse events. Methods The present study was conducted in a prospective, randomized, single-blind, controlled manner on 80 patients, who underwent septoplasty procedures under general anesthesia, after dividing them randomly into two groups according to the device used (LMA-S or ETT). The presence of blood in the airway (glottis/trachea, distal trachea) was analyzed with the fiberoptic bronchoscope and a four-point scale. Both groups were evaluated for OLP; HR; MAP; postoperative sore throat, nausea, and vomiting; dysphagia; and dysphonia. Results In the fiberoptic evaluation of the airway postoperatively, less blood leakage was detected in both anatomic areas in the LMA-S group than in the ETT group (glottis/trachea, p = 0.004; distal trachea, p = 0.034). Sore throat was detected less frequently in the LMA-S group at a significant level in the 2nd, 6th, and 12th hours of postoperative period; however, other adverse events were similar in both groups. Hemodynamic parameters were not different between the two groups. Conclusion The present findings demonstrate that the LMA-S provided more effective airway protection than the ETT in preventing blood leakage in the septoplasty procedures. We believe that the LMA-S can be used safely and as an alternative to the ETT in septoplasty cases. Trial registration This trial is registered at the US National Institutes of Health (ClinicalTrials.gov) # NCT03903679 on April 5, 2019.

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A Comparison of Laryngeal Mask Airway-Supreme and Endotracheal Tube Use with respect to Airway Protection in Patients Undergoing Septoplasty: A Randomized, Single-blind, Controlled Clinical Trial

10.21203/rs.2.16470/v1 ◽

2019 ◽

Author(s):

Erol Karaaslan ◽

Sedat Akbas ◽

Ahmet Selim Ozkan ◽

Cemil Colak ◽

Zekine Begec

Keyword(s):

Laryngeal Mask Airway ◽

Endotracheal Tube ◽

Sore Throat ◽

Fiberoptic Bronchoscopy ◽

Laryngeal Mask ◽

Controlled Clinical Trial ◽

Airway Protection ◽

Secondary Purpose ◽

Single Blind ◽

Laryngeal Mask Airway Supreme

Abstract Background There are doubts among anesthesiologists on the use of the Laryngeal Mask Airway in nasal surgeries because of concerns about the occurrence of blood leakages to the airway. The primary purpose of this study on septoplasty cases was to compare Laryngeal Mask Airway-Supreme (LMA-S) and endotracheal tube (ETT) use in protecting the airway against blood leakage, as evident through the fiberoptic bronchoscopy method. The secondary purpose of the study was to evaluate oropharyngeal leakage pressure (OLP), heart rate (HR), mean arterial pressure (MAP), and postoperative adverse events.Methods The present study was conducted in a prospective, randomized, single-blind, controlled manner on 80 patients, who underwent septoplasty procedures under general anesthesia, after dividing them randomly into two groups according to the device used (LMA-S or ETT). The presence of blood in the airway (glottis/trachea, distal trachea) was analyzed with the fiberoptic bronchoscope and a four-point scale. Both groups were evaluated for OLP; HR; MAP; postoperative sore throat, nausea, and vomiting; dysphagia; and dysphonia.Results In the fiberoptic evaluation of the postoperative airway, less blood leakage was detected in both anatomic areas in the LMA-S group than in the ETT group (glottis/trachea, p = 0.004; distal trachea, p = 0.034). Sore throat was detected less frequently in the LMA-S group at a significant level in the 2nd, 6th, and 12th hours of postoperative period; however, other adverse events were similar in both groups. Hemodynamic parameters were not significantly different between the two groups.Conclusion The present findings demonstrate that the LMA-S provided more effective airway protection than the ETT in preventing blood leakage in the septoplasty procedures. We believe that the LMA-S can be used safely and as an alternative to the ETT in septoplasty cases.

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Laryngeal mask airway reduces incidence of post-operative sore throat after thyroid surgery compared with endotracheal tube: a single-blinded randomized controlled trial

BMC Anesthesiology ◽

10.1186/s12871-020-0932-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yahong Gong ◽

Xiaohan Xu ◽

Jin Wang ◽

Lu Che ◽

Weijia Wang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Laryngeal Mask Airway ◽

Endotracheal Tube ◽

Sore Throat ◽

Thyroid Surgery ◽

Controlled Trial ◽

Laryngeal Mask ◽

Randomized Controlled

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Laryngeal mask airway reduces incidence of post-operative sore throat after thyroid surgery compared with endotracheal tube: a single-blinded randomized controlled trial

10.21203/rs.2.13336/v1 ◽

2019 ◽

Author(s):

Yahong Gong ◽

Xiaohan Xu ◽

Jin Wang ◽

Lu Che ◽

Weijia Wang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Laryngeal Mask Airway ◽

Endotracheal Tube ◽

Sore Throat ◽

Thyroid Surgery ◽

Cuff Pressure ◽

Controlled Trial ◽

Laryngeal Mask ◽

Postoperative Sore Throat ◽

Randomized Controlled

Abstract BackgroundSore throat is a remarkable complication after thyroid surgery with endotracheal tube (ETT). Many studies revealed that laryngeal mask airway (LMA) might reduce the incidence and severity of postoperative sore throat. However, little is known about the use of a flexible reinforced LMA (FLMA) in thyroid surgery. The purpose of this study was to explore the potential benefits of FLMA compared with ETT on postoperative sore throat.MethodsIn this prospective, single-blinded, randomized, controlled trial, ninety-six patients aged 20-80 years, scheduled for elective radical thyroidectomy under general anesthesia were enrolled. They were randomly divided into ETT group and FLMA group. All the included patients received total intravenous anesthesia (with propofol, fentanyl and rocuronium) and controlled mechanical ventilation during the surgery. Cuff pressure of ETT and FLMA were strictly controlled. Incidence and severity of postoperative sore throat, numbness and hoarseness at 1, 24, and 48 h after surgery was evaluated and compared between the two groups. Incidence and severity of buckling during extubation and the hemodynamic profile during intubation were also recorded and compared.ResultsThe incidence of sore throat and hoarseness was significantly lower in FLMA group than those in ETT group at 1h, 24h and 48h postoperatively, as well as the severity of sore throat. Compared to ETT group, there was a significantly lower incidence of buckling during extubation and less fluctuation of HR and BP at 1min and 3min after intubation in FLMA group.ConclusionsPostoperative sore throat and hoarseness was improved in patients undergoing thyroid surgery with FLMA when compared with ETT. The use of FLMA also achieved less buckling during extubation and better hemodynamic profiles during intubation.

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

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20185108 ◽

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.

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Laryngeal mask airway reduces incidence of post-operative sore throat after thyroid surgery compared with endotracheal tube: a single-blinded randomized controlled trial

10.21203/rs.2.13336/v3 ◽

2019 ◽

Author(s):

Yahong Gong ◽

Xiaohan Xu ◽

Jin Wang ◽

Lu Che ◽

Weijia Wang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Laryngeal Mask Airway ◽

Endotracheal Tube ◽

Sore Throat ◽

Thyroid Surgery ◽

Cuff Pressure ◽

Controlled Trial ◽

Laryngeal Mask ◽

Postoperative Sore Throat ◽

Randomized Controlled

Abstract Background: Sore throat is a remarkable complication after thyroid surgery with endotracheal tube (ETT). Many studies revealed that laryngeal mask airway (LMA) might reduce the incidence and severity of postoperative sore throat. However, little is known about the use of a flexible reinforced LMA (FLMA) in thyroid surgery. The purpose of this study was to explore the potential benefits of FLMA compared with ETT on postoperative sore throat. Methods:In thisprospective, single-blinded, randomized, controlled trial, ninety-six patients aged 20-80 years, scheduled for elective radical thyroidectomy under general anesthesia were enrolled. They were randomly divided into ETT group and FLMA group. All the included patients received total intravenous anesthesia (with propofol, fentanyl and rocuronium) and controlled mechanical ventilation during the surgery. Cuff pressure of ETT and FLMA were strictly controlled. Incidence and severity of postoperative sore throat, numbness and hoarseness at 1, 24, and 48 h after surgery was evaluated and compared between the two groups. Incidence and severity of buckling during extubation and the hemodynamic profile during intubation were also recorded and compared. Results:The incidence of sore throat and hoarseness was significantly lower in FLMA group than those in ETT group at 1h, 24h and 48h postoperatively, as well as the severity of sore throat. Compared to ETT group, there was a significantly lower incidence of buckling during extubation and less fluctuation of HR and BP at 1min and 3min after intubation in FLMA group. Conclusions:Patients undergoing thyroid surgery with FLMA had less postoperative laryngopharyngeal symptoms when compared with ETT. The use of FLMA also achieved less buckling during extubation and better hemodynamic profiles during intubation.

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