Preliminary evaluation of SaCoVLM™ video laryngeal mask airway in airway management for general anesthesia

Abstract Background To preliminary evaluate the application of SaCoVLM™ video laryngeal mask airway in airway management of general anesthesia. Methods We recruited 100 adult patients (ages 18–78 years, male 19, female 81, weight 48–90 kg) with normal predicted airway (Mallampati I ~ II, unrestricted mouth opening, normal head and neck mobility) and ASA I-II who required general anaesthesia. The SaCoVLM™ was inserted after anesthesia induction and connected with the anesthesia machine for ventilation. Our primary outcome was glottic visualization grades. Secondary outcomes included seal pressure, success rate of insertion, intraoperative findings (gastric reflux and contraposition), gastric drainage and 24-h complications after operation. Results The laryngeal inlet was exposed in all the patients and shown on the video after SaCoVLM™ insertion. The status of glottic visualization was classified: grade 1 in 55 cases, grade 2 in 23 cases, grade 3 in 14 cases and grade 4 in 8 cases. The first-time success rate of SaCoVLM™ insertion was 95% (95% CI = 0.887 to 0.984), and the total success rate was 96% (95% CI = 0.901 to 0.989). The sealing pressure of SaCoVLM™ was 34.1 ± 6.2 cmH2O and the gastric drainage were smooth. Only a small number of patients developed mild complications after SaCoVLM™ was removed (such as blood stains on SaCoVLM™ and sore throat). Conclusions The SaCoVLM™ can visualize partial or whole laryngeal inlets during the surgery, with a high success rate, a high sealing pressure and smooth gastroesophageal drainage. SaCoVLM™ could be a promise new effective supraglottic device to airway management during general anesthesia. Trial registration ChiCTR,ChiCTR2000028802.Registered 4 January 2020.

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Comparison of the Jcerity Endoscoper Airway with the LMA Supreme for Airway Management in Patients Undergoing Cerebral Aneurysm Embolization

10.21203/rs.3.rs-847303/v1 ◽

2021 ◽

Author(s):

Junfei Zhou ◽

Lu Li ◽

Fang Wang ◽

Yunqi Lv

Keyword(s):

Laryngeal Mask Airway ◽

Airway Management ◽

Success Rate ◽

Cerebral Aneurysm ◽

Cerebral Aneurysms ◽

Laryngeal Mask ◽

Aneurysm Embolization ◽

Perioperative Anticoagulation ◽

Lma Supreme ◽

Sealing Pressure

Abstract Background Interventional embolization of cerebral aneurysms often requires anticoagulation and antiplatelet therapy during perioperative period. A new type of laryngeal mask airway (Jcerity Endoscoper Airway)with a unique design may cause less oropharyngeal injury and bleeding for patients receiving perioperative anticoagulation. This study sought to compare the efficacy, safety and complications of Jcerity Endoscoper airwayvs LMA((Laryngeal Mask Airway) Supreme in the procedure of cerebral aneurysm embolization. Methods In this prospective, randomised clinical trial, 182 adult patients with American Society of Anesthesiologists class Ι-II scheduled for interventional embolization of cerebral aneurysms were randomly allocated into the Jcerity Endoscoper airway group and the LMA Supreme group. We compared success rate of LMA implantation, ventilation quality, airway sealing pressure, peak airway pressure, degree of blood staining, postoperative oral hemorrhage, sore throat and other complications between the groups. Results There were no significant differences between the groups in terms of success rate of LMA implantation, ventilation quality, airway sealing pressure or airway peak pressure. The LMA Supreme group showed a significantly higher degree of blood staining than the Jcerity Endoscoper airway group when the laryngeal mask airway was removed (P = 0.04), and there were also more oral hemorrhages and pharyngeal pain than in the the Jcerity Endoscoper airway group (P = 0.03,P = 0.02). No differences were observed between groups in terms of other complications related to the LMA. Conclusions The Jcerity Endoscoper airway can be safely and effectively used for airway management in patients undergoing cerebral aneurysm embolization, which can significantly reduce airway complications related to perioperative anticoagulation.

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Intubating Laryngeal Mask Airway

Anaesthesia and Intensive Care ◽

10.1177/0310057x0203000503 ◽

2002 ◽

Vol 30 (5) ◽

pp. 551-569 ◽

Cited By ~ 45

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.

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A prospective, randomized comparative study for use of proseal laryngeal mask airway as an alternative to endotracheal intubation for airway management in children under general anesthesia

Indian Journal of Clinical Anaesthesia ◽

10.5958/2394-4994.2016.00017.2 ◽

2016 ◽

Vol 3 (1) ◽

pp. 80

Author(s):

Leena Goel ◽

Sambhram Shenoy ◽

Shivam Goel

Keyword(s):

Laryngeal Mask Airway ◽

Comparative Study ◽

Airway Management ◽

General Anesthesia ◽

Endotracheal Intubation ◽

Proseal Laryngeal Mask Airway ◽

Laryngeal Mask

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Airway Management with the Laryngeal Mask Airway (LMA) in Emergency Medical Services

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.s01.12131 ◽

2021 ◽

Vol 104 (Suppl. 1) ◽

pp. S8-S11

Keyword(s):

Laryngeal Mask Airway ◽

Airway Management ◽

Oxygen Saturation ◽

Emergency Medical Services ◽

Success Rate ◽

Laryngeal Mask ◽

High Success Rate ◽

Medical Services ◽

Supraglottic Airway ◽

Emergency Medical

Background: Airway management is an important aspect of care in emergency medical services (EMS) used to prevent obstruction of the respiratory track and inadequate oxygenation. The laryngeal mask airway (LMA) is an easy-to-use supraglottic airway device developed in 1988 that has a high success rate in both adults and children. However, there have yet been no studies regarding LMA use in EMS in Thailand. Objective: To determine the success rate of LMA in EMS and factors associated with successful LMA insertion. Materials and Methods: This was a cross-sectional study consisting of Srinagarind Hospital EMS patients over 18 years of age who underwent LMA airway management between March 2016 and March 2020. Data were collected from the Srinagarind Hospital EMS operation database and hospital information database system. Results: A total of 154 patients were enrolled with a mean age of 43.1+8.5 years, 89 (57.8%) of whom were male. Non trauma patients accounted for 72.7% of all cases. The average oxygen saturation before and after LMA use were 71.4+12.3% and 94.4+3.2%, respectively (p = 0.022). Students in their first and third year of residency training were able to successfully perform LMA airway management on the first attempt in 83.3% and 98.4% of cases, respectively (p = 0.025). Conclusion: Airway management using the LMA had a high success rate on the first attempt, required less time for insertion than other comparable devices, and resulted in a high level of oxygen saturation. Keywords: Laryngeal mask airway, Emergency medical services, Airway management, Internship and residency

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Comparison of Supreme laryngeal mask airway versus endotracheal intubation for airway management during general anesthesia for cesarean section: a randomized controlled trial

BMC Anesthesiology ◽

10.1186/s12871-019-0792-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Wei Yu Yao ◽

Shi Yang Li ◽

Yong Jin Yuan ◽

Hon Sen Tan ◽

Nian-Lin R. Han ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Laryngeal Mask Airway ◽

Cesarean Section ◽

Airway Management ◽

General Anesthesia ◽

Endotracheal Intubation ◽

Controlled Trial ◽

Laryngeal Mask ◽

Randomized Controlled

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Crossover Comparison of the Laryngeal Mask Supreme™ and the i-gel™ in Simulated Difficult Airway Scenario in Anesthetized Patients

Anesthesiology ◽

10.1097/aln.0b013e3181a4c6b9 ◽

2009 ◽

Vol 111 (1) ◽

pp. 55-62 ◽

Cited By ~ 100

Author(s):

Lorenz G. Theiler ◽

Maren Kleine-Brueggeney ◽

Dagmar Kaiser ◽

Natalie Urwyler ◽

Cedric Luyet ◽

...

Keyword(s):

United Kingdom ◽

Airway Management ◽

Difficult Airway ◽

Success Rate ◽

Mouth Opening ◽

Laryngeal Mask ◽

Insertion Time ◽

Leak Pressure ◽

Neck Movement ◽

Airway Devices

Background The single-use supraglottic airway devices LMA-Supreme (LMA-S; Laryngeal Mask Company, Henley-on-Thames, United Kingdom) and i-gel (Intersurgical Ltd, Wokingham, Berkshire, United Kingdom) have a second tube for gastric tube insertion. Only the LMA-S has an inflatable cuff. They have the same clinical indications and might be useful for difficult airway management. This prospective, crossover, randomized controlled trial was performed in a simulated difficult airway scenario using an extrication collar limiting mouth opening and neck movement. Methods Sixty patients were included. Both devices were placed in random order in each patient. Primary outcome was overall success rate. Other measurements were time to successful ventilation, airway leak pressure, fiberoptic glottic view, and adverse events. Results Success rate for the LMA-S was 95% versus 93% for the i-gel (P = 1.000). LMA-S needed shorter insertion time (34 +/- 12 s vs. 42 +/- 23 s, P = 0.024). Tidal volumes and airway leak pressure were similar (LMA-S 26 +/- 8 cm H20; i-gel 27 +/- 9 cm H20; P = 0.441). Fiberoptic view through the i-gel showed less epiglottic downfolding. Overall agreement in insertion outcome was 54 (successes) and 1 (failure) or 55 (92%) of 60 patients. The difference in success rate was 1.7% (95% CI -11.3% to 7.6%). Conclusions Both airway devices had similar insertion success and clinical performance in the simulated difficult airway situation. The authors found less epiglottic downfolding and better fiberoptic view but longer insertion time with the i-gel. Our study shows that both devices are feasible for emergency airway management in patients with reduced neck movement and limited mouth opening.

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Teaching Airway Management on Anaesthetised Patients

Scottish Medical Journal ◽

10.1177/003693309403900405 ◽

1994 ◽

Vol 39 (4) ◽

pp. 111-113 ◽

Cited By ~ 2

Author(s):

P. D. Martin ◽

W. A. Chambers

Keyword(s):

Clinical Practice ◽

Laryngeal Mask Airway ◽

Tracheal Intubation ◽

Airway Management ◽

General Anaesthesia ◽

Laryngeal Mask ◽

Number Of Patients

In order to assess the availability of appropriate resources for a programme of in-theatre teaching of airway skills using anaesthetised patients, two surveys of airway management on anaesthetised patients with identification of those suitable for teaching airway care; and a questionnaire to senior anaesthetists assessing attitudes to such teaching were performed. The results demonstrated that, of all patients undergoing general anaesthesia 45% were intubated and of these 29% were regarded as suitable for teaching intubation. The introduction of the Laryngeal Mask Airway (LMA) into clinical practice has reduced the number of patients having their airways maintained by either bag and mask or tracheal intubation, with implications for learning those skills. In our survey 16% had a Laryngeal Mask Airway (LMA) placed for airway securement and of these 29% would have been intubated had the LMA not been available. Finally, amongst anaesthetists in our survey there is a wide variety of attitudes to teaching airway skills using anaesthetised patients.

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Comparison of Supreme laryngeal mask airway versus endotracheal intubation for airway management during general anesthesia for Cesarean section: a randomized controlled trial

10.21203/rs.2.287/v2 ◽

2019 ◽

Author(s):

Wei Yu Yao ◽

Shi Yang Li ◽

Yong Jin Yuan ◽

Hon Sen Tan ◽

Nian-Lin Reena Han ◽

...

Keyword(s):

Laryngeal Mask Airway ◽

Cesarean Section ◽

Airway Management ◽

General Anesthesia ◽

Endotracheal Intubation ◽

Airway Device ◽

Laryngeal Mask ◽

Elective Cesarean Section ◽

Randomized Controlled ◽

Reduced Time

Abstract Background The obstetric airway is a significant cause of maternal morbidity and mortality. Endotracheal intubation is considered the standard of care but the laryngeal mask airway (LMA) has gained acceptance as a rescue airway and has been incorporated into the obstetric airway management guidelines. In this randomized controlled equivalence trial, we compared the Supreme LMA (SLMA) with endotracheal intubation (ETT) in managing the obstetric airway during cesarean section. Methods Parturients who underwent elective cesarean section under general anesthesia were randomized to receive either an SLMA or ETT as their airway device. Our primary outcome was first-attempt insertion success. Successful insertion was defined as adequate bilateral air entry with auscultation and the presence of end-tidal carbon dioxide on the capnogram. The first-attempt insertion success rate was compared using the Chi-Square test. Secondary outcomes included time-to-ventilation, seal pressure, ventilation/hemodynamic parameters, occurrence of clinical aspiration, foetal outcomes, and maternal side effects associated with the airway device. Results We recruited 920 parturients (460 SLMA, 460 ETT) who underwent elective Caesarean section under general anesthesia. Patient characteristics were similar between the groups. First attempt success was similar (Odds Ratio--ORSLMA/ETA: 1.00 (95%CI: 0.25, 4.02), p = 1.0000). SLMA was associated with reduced time to effective ventilation (Mean Difference--MD -22.96; 95%CI: -23.71, -22.21 seconds) compared to ETT group (p<0.0001). Ventilation parameters, maternal and fetal outcomes were similar between the groups, and there was no aspiration. Conclusions SLMA could be an alternative airway management technique for a carefully selected low-risk obstetric population, with similar insertion success rates, reduced time to ventilation and less hemodynamic changes compared with ETT. Our findings are consistent with the airway guidelines in recommending the second line use of LMA in the management of obstetric airway.

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