scholarly journals Correlation and variation of cuff inflating volumes and pressures in different adult models of laryngeal mask: a prospective randomized trial

2020 ◽  
Author(s):  
Narut Ruananukun ◽  
Jittiya Watcharotayangul ◽  
Suchaya Jeeranukosol ◽  
Rojnarin Komonhirun
Keyword(s):  
Clinical Trials ◽  
General Anesthesia ◽  
Randomized Trial ◽  
Laryngeal Mask ◽  
Intracuff Pressure ◽  
Laryngeal Masks ◽  
Airway Complications ◽  
Soft Seal ◽  
Mask Size ◽  
Clinical Trials Registry

Abstract Background: Hyperinflation of laryngeal mask cuffs may carry the risk of airway complications. The manufacturer recommends inflating cuff until the intracuff pressure reaches 60 cmH2O, or inflate with the volume of air to not exceed the maximum recommended volume. We prospectively assessed the correlation of cuff inflating volumes and pressures, and the appropriated the cuff inflating volumes to generate an intracuff pressure of 60 cmH2O in the adult laryngeal masks from different manufacturers. Methods: Two groups of eighty patients requiring laryngeal mask size 3 and 4 during general anesthesia were randomized into 4 subgroups for each size of the laryngeal mask: Soft Seal® (Portex®), AuraOnceTM (Ambu®), LMA-ClassicTM (Teleflex®) and LMA-ProSealTM (Teleflex®). After insertion, the cuff was inflated with 5-ml increments of air up to the maximum recommended volume. After each 5-ml intracuff pressure was measured, the volume of air that generated the intracuff pressure of 60 cmH2O was recorded. Results: Mean(SD) volume of air required to achieve the intracuff pressure of 60 cmH2O in Soft Seal®, AuraOnceTM, LMA-ClassicTM, LMA-ProSealTM laryngeal mask size 3 were 11.80(1.88), 9.20(1.88), 8.95(1.50) and 13.50(2.48) ml, respectively, and these volumes in laryngeal mask size 4 were 14.45(4.12), 12.55(1.85), 11.30(1.95) and 18.20(3.47) ml, respectively. The maximum recommended volume resulted in high intracuff pressures (>60 cmH2O) in all laryngeal mask types and sizes studied. Conclusion: Pressure-volume curves of adult laryngeal masks are all in sigmoidal shape. Cuff designs and materials can effect pressure and volume correlation. Approximately half of the maximum recommended volume is required to achieve the intracuff pressure of 60 cmH2O except LMA-ProSealTM which required two-thirds of the maximum recommended volume. Trial registration: Thai Clinical Trials Registry, TCTR20150602001, May 28, 2015

scholarly journals Correlation and variation of cuff inflating volumes and pressures in the adult laryngeal masks: a prospective randomized trial

2019 ◽  
Author(s):  
Narut Ruananukun ◽  
Jittiya Watcharotayangul ◽  
Suchaya Jeeranukosol ◽  
Rojnarin Komonhirun
Keyword(s):  
Clinical Trials ◽  
General Anesthesia ◽  
Randomized Trial ◽  
Laryngeal Mask ◽  
Intracuff Pressure ◽  
Laryngeal Masks ◽  
Airway Complications ◽  
Soft Seal ◽  
Mask Size ◽  
Clinical Trials Registry

Abstract Background: Hyperinflation of laryngeal mask cuffs may carry the risk of airway complications. The manufacturer recommends inflating cuff until the intracuff pressure reaches 60 cmH2O, or inflate with the volume of air to not exceed the maximum recommended volume. We prospectively assessed the correlation of cuff inflating volumes and pressures, and the appropriated the cuff inflating volumes to generate an intracuff pressure of 60 cmH2O in the adult laryngeal masks from different manufacturers. Methods: Two groups of eighty patients requiring laryngeal mask size 3 and 4 during general anesthesia were randomized into 4 subgroups for each size of the laryngeal mask: Soft Seal® (Portex®), AuraOnceTM (Ambu®), LMA-ClassicTM (Teleflex®) and LMA-ProSealTM (Teleflex®). After insertion, the cuff was inflated with 5-ml increments of air up to the maximum recommended volume. After each 5-ml intracuff pressure was measured, the volume of air that generated the intracuff pressure of 60 cmH2O was recorded. Results: Mean(SD) volume of air required to achieve the intracuff pressure of 60 cmH2O in Soft Seal®, AuraOnceTM, LMA-ClassicTM, LMA-ProSealTM laryngeal mask size 3 were 11.80(1.88), 9.20(1.88), 8.95(1.50) and 13.50(2.48) ml, respectively, and these volumes in laryngeal mask size 4 were 14.45(4.12), 12.55(1.85), 11.30(1.95) and 18.20(3.47) ml, respectively. The maximum recommended volume resulted in high intracuff pressures (>60 cmH2O) in all laryngeal mask types and sizes studied. Conclusion: Approximately half of the maximum recommended volume is required to achieve the intracuff pressure of 60 cmH2O except LMA-ProSealTM which required two-thirds of the maximum recommended volume. Trial Registration: Thai Clinical Trials Registry, TCTR20150602001, May 28, 2015. Keywords: Laryngeal mask, cuff inflating volume, intracuff pressure.

scholarly journals Correlation and variation of cuff inflating volumes and pressures in different adult models of laryngeal mask airway: a prospective randomized trial

2019 ◽  
Author(s):  
Narut Ruananukun ◽  
Jittiya Watcharotayangul ◽  
Suchaya Jeeranukosol ◽  
Rojnarin Komonhirun
Keyword(s):  
Clinical Trials ◽  
Laryngeal Mask Airway ◽  
General Anesthesia ◽  
Laryngeal Mask ◽  
Intracuff Pressure ◽  
Laryngeal Masks ◽  
Airway Complications ◽  
Soft Seal ◽  
Mask Size ◽  
Clinical Trials Registry

Abstract Background : Hyperinflation of laryngeal mask cuffs may carry the risk of airway complications. The manufacturer recommends inflating cuff until the intracuff pressure reaches 60 cmH 2 O, or inflate with the volume of air to not exceed the maximum recommended volume. We prospectively assessed the correlation of cuff inflating volumes and pressures, and the appropriated the cuff inflating volumes to generate an intracuff pressure of 60 cmH 2 O in the adult laryngeal masks from different manufacturers. Methods : Two groups of eighty patients requiring laryngeal mask size 3 and 4 during general anesthesia were randomized into 4 subgroups for each size of the laryngeal mask: Soft Seal ® (Portex ® ), AuraOnce TM (Ambu ® ), LMA-Classic TM (Teleflex ® ) and LMA-ProSeal TM (Teleflex ® ). After insertion, the cuff was inflated with 5-ml increments of air up to the maximum recommended volume. After each 5-ml intracuff pressure was measured, the volume of air that generated the intracuff pressure of 60 cmH 2 O was recorded . Results : Mean(SD) volume of air required to achieve the intracuff pressure of 60 cmH 2 O in Soft Seal ® , AuraOnce TM , LMA-Classic TM , LMA-ProSeal TM laryngeal mask size 3 were 11.80(1.88), 9.20(1.88), 8.95(1.50) and 13.50(2.48) ml, respectively, and these volumes in laryngeal mask size 4 were 14.45(4.12), 12.55(1.85), 11.30(1.95) and 18.20(3.47) ml, respectively. The maximum recommended volume resulted in high intracuff pressures (>60 cmH 2 O) in all laryngeal mask types and sizes studied. Conclusion : Pressure-volume curves of adult laryngeal masks are all in sigmoidal shape. Cuff designs and materials can effect pressure and volume correlation. Approximately half of the maximum recommended volume is required to achieve the intracuff pressure of 60 cmH 2 O except LMA-ProSeal TM which required two-thirds of the maximum recommended volume. Trial registration: Thai Clinical Trials Registry, TCTR20150602001, May 28, 2015

Intracuff Pressure Monitoring during Nitrous Oxide Anesthesia when Using the Soft Seal® Laryngeal Mask

2004 ◽  
Vol 101 (1) ◽  
pp. 265-265
Author(s):  
André Van Zundert ◽  
Baha Al-Shaikh ◽  
Kristine Fonck ◽  
Eric Mortier
Keyword(s):  
Nitrous Oxide ◽  
Laryngeal Mask ◽  
Intracuff Pressure ◽  
Pressure Monitoring ◽  
Soft Seal ◽  
Oxide Anesthesia

Maternal and Neonatal Effect of Fentanyl as a Premedication before Induction of General Anesthesia in Cesarean Surgery: A Systematic Review and Meta-analysis of Randomized Clinical Trials

2019 ◽  
Vol 15 (4) ◽  
pp. 232-237
Author(s):  
Mir Hadi Musavi ◽  
Behzad Jodeiri ◽  
Keyvan Mirnia ◽  
Morteza Ghojazadeh ◽  
Zeinab Nikniaz
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Apgar Score ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Intravenous Fentanyl ◽  
Neonatal Effect ◽  
Fentanyl Group

Background: Although, some clinical trials investigated the maternal and neonatal effect of fentanyl as a premedication before induction of general anesthesia in cesarean section, to the best of our knowledge, there is no systematic review to summarize these results. Objectives: The present systematic review and meta-analysis evaluated the maternal and neonatal effect of intravenous fentanyl as a premedication before induction of general anesthesia in cesarean section. Methods: The databases of Pubmed, Embase, Scopus and Cochrane library were searched till July 2017 to identify randomized clinical trials which evaluated the effects of intravenous fentanyl as a premedication before induction of general anesthesia compared with placebo on neonate first and fifth minute Apgar score and maternal heart rate and mean arterial pressure (MAP) in cesarean section. Standard Mean difference (SMD) was calculated and I-square statistic test was used for heterogeneity analysis. Results: The present systematic review and meta-analysis consisted of three clinical trials including 180 women in labor. Considering the results of meta-analysis, there is no significant differences between fentanyl and placebo in the case of Apgar score at 1 minute; however, the Apgar score of 5 minutes was significantly lower in fentanyl group compared with placebo (SMD -0.68, 95%CI: - 0.98, -0.38, p<0.001). In the term of maternal hemodynamics, the heart rate (SMD -0.43, 95%CI: - 0.72, -0.13, p=0.004) and MAP (SMD -0.78, 95% CI: -1.09, -0.48, p<0.001) in fentanyl group were significantly lower compared with placebo group. Conclusion: The present meta-analysis showed that using intravenous fentanyl as a premedication before induction of general anesthesia had adverse effects on neonate Apgar score. However, it had positive effects on preventing adverse consequences of intubation on maternal hemodynamics.

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