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

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.

Pulmonary Airway Resistance with the Endotracheal Tube versus Laryngeal Mask Airway in Paralyzed Anesthetized Adult Patients 

1999 ◽  
Vol 90 (2) ◽  
pp. 395-397 ◽  
Author(s):  
Alison Berry ◽  
Joseph Brimacombe ◽  
Christian Keller ◽  
Chandi Verghese
Keyword(s):  
Laryngeal Mask Airway ◽  
Endotracheal Tube ◽  
Airway Pressure ◽  
Airway Resistance ◽  
Adult Patients ◽  
Laryngeal Mask ◽  
Peak Airway Pressure ◽  
Device Resistance ◽  
The Mean ◽  
Pulmonary Airway

Background The hypothesis that airway resistance is less with the laryngeal mask airway than with the endotracheal tube was tested. Methods Thirty-six paralyzed, anesthetized adult patients with no respiratory disease (American Society of Anesthesiologists physical status 1-3; age, 18-80 yr) were randomly allocated (9 men, 9 women in each group) to receive either a size-4 laryngeal mask airway or an endotracheal tube (men, 9-mm ID; women, 8-mm ID). A pulmonary monitor with flow transducer and esophageal balloon was used to measure peak airway pressure and mean airway resistance (device resistance plus pulmonary airway resistance) at three different tidal volumes (5, 10, and 15 ml/kg). Device resistance was measured in vitro with the distal end of the endotracheal tube or laryngeal mask airway open to the atmosphere and using the same ventilator settings. Pulmonary airway resistance was derived by subtracting the mean device resistance from the mean airway resistance. Results Peak airway pressure, mean airway resistance, device resistance, and pulmonary airway resistance were greater for the endotracheal tube (all P < 0.0001). Conclusions The laryngeal mask airway triggers less bronchoconstriction than does the endotracheal tube in paralyzed anesthetized adult patients. This may have implications for maintaining intraoperative pulmonary function and reducing the risk for atelectasis and pulmonary infection.

scholarly journals 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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Erol Karaaslan ◽  
Sedat Akbas ◽  
Ahmet Selim Ozkan ◽  
Cemil Colak ◽  
Zekine Begec
Keyword(s):  
Laryngeal Mask Airway ◽  
Adverse Events ◽  
Endotracheal Tube ◽  
Sore Throat ◽  
Fiberoptic Bronchoscopy ◽  
Laryngeal Mask ◽  
Controlled Clinical Trial ◽  
Airway Protection ◽  
Link Type ◽  
Single Blind

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.

Comparison of Proseal Laryngeal Mask Airway Versus Endotracheal Tube in Anaesthetized Adult Patients

2018 ◽  
Vol 5 (3) ◽  
pp. 415-418
Author(s):  
Saranjit Singh ◽  
◽  
Sapna Bansal ◽  
Rahul Midda ◽  
Dhanwant Kaur ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Endotracheal Tube ◽  
Proseal Laryngeal Mask Airway ◽  
Adult Patients ◽  
Laryngeal Mask

A Randomized Crossover Comparison of Airway Sealing with the Laryngeal Mask Airway Ambu AuraFlex at Three Intracuff Pressures in Pediatric Laparoscopic Surgery

2019 ◽  
Author(s):  
Xiang Liu ◽  
Xiaona Tan ◽  
Qi Zhang ◽  
Li Qiao ◽  
Lei Shi
Keyword(s):  
Laparoscopic Surgery ◽  
Laryngeal Mask Airway ◽  
Airway Pressure ◽  
Laryngeal Mask ◽  
Peak Airway Pressure ◽  
Supraglottic Airway ◽  
Intracuff Pressure ◽  
Leak Pressure ◽  
Oropharyngeal Leak Pressure ◽  
Mucosal Change

Abstract Objective An adequate intracuff pressure is important to ensure sufficient sealing function when using supraglottic airway devices to protect the airway from secretions and achieve adequate positive pressure ventilation. The aim of this study is to analyze a feasible and effective alternative Ambu AuraFlex intracuff pressure in child's laparoscopic surgery. Study Design Seventy-two children were included in this study. After insertion of the laryngeal mask airway AuraFlex, oropharyngeal leak pressure (OLP) was measured at intracuff pressures of 10, 30, and 60-cmH2O according to one of six sequences produced on the basis of 3 × 6 Williams crossover design. During the intraoperative period, AuraFlex was maintained using the last intracuff pressure of the allocated sequence. Oropharyngeal leak pressure, peak airway pressure, the fiberoptic view, mucosal change, and complications were assessed at three intracuff pressures. Results The OLP at the intracuff pressure of 10 cmH2O was significantly lower than that of 30 cmH2O (2# 18.1 ± 1.5 vs. 19.5 ± 1.4 cmH2O, p = 0.001; 2.5# 17.7 ± 1.2 vs. 20.2 ± 1.4, p = 0.001) and 60 cmH2O (2# 18.1 ± 1.5 vs. 20.0 ± 1.3 cmH2O, p = 0.002; 2.5# 17.7 ± 1.2 vs. 20.8 ± 1.1, p = 0.003). Compared with the peak airway pressure in pre-and postpneumoperitoneum, the OLP was significantly higher. Subgroup analysis showed no differences in mucosal change and complications. Conclusion Intracuff pressures of 30 may be sufficient for the Ambu AuraFlex in child's laparoscopic surgery, and there may be no added benefit of an intracuff pressure of 60 cmH2O, as oropharyngeal leak pressures were similar.

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

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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