scholarly journals A Comparison between a Two Person Insertion Technique of Laryngeal Mask Airway and the Classic One Person Technique

2013 ◽  
Vol 2 (4) ◽  
pp. 179-182
Author(s):  
Asef Parviz Kazemi ◽  
Mohammad Ali Daneshforooz ◽  
Shahriar Omidvari
Keyword(s):  
Carbon Dioxide ◽  
Laryngeal Mask Airway ◽  
Mouth Opening ◽  
Laryngeal Mask ◽  
New Technique ◽  
P Value ◽  
Classic Method ◽  
Carbon Dioxide Pressure ◽  
End Tidal ◽  
Rate Of Success

Background: Various studies are seeking to find new methods to improve techniques of laryngeal mask airway (LMA) insertion and reduce possible complications. In this study, we embarked on a clinical study to investigate the advantages of a new insertion method of laryngeal mask and to compare it with the classic method.Materials and Methods: Two hundred patients aged 20-60 years old in 2012 were randomly divided into two groups allocated to receive either the new technique of insertion of LMA (two-person method) or the classic method (one-person method). In the two person method, jaw thrust and mouth opening is done by a technician and then anesthesiologist inserts the LMA. Oxygen saturation, time to insert laryngeal mask, end-tidal carbon dioxide pressure, and the ease of insertion in both groups were measured. The collected data were analyzed by using ANOVA test. P-value< 0.05 was considered as statistically significant.Results: The measured end-tidal pressure of carbon dioxide (ETCO2) and saturation of O2 were 31.68 mmHg and 98.87 % in the classic method and 30.47 mmHg and 99.42 % in the two-person method, respectively. These differences were statistically significant for both values. However, the discrepancy of insertion time and ease of insertion between the two groups were not statistically considerable.Conclusion: The new technique introduced in this study is associated with higher rate of success, as evidenced by enhancement of saturation of O2 and reduction of ETCO2. Therefore, this method could be considered as a safe and effective method in order to establish a secure airway in anesthetized patients in future studies.

Comparison of End-Tidal and Arterial Carbon Dioxide in Infants Using Laryngeal Mask Airway and Endotracheal Tube

1997 ◽  
Vol 84 (1) ◽  
pp. 51-53 ◽  
Author(s):  
Ashwani K. Chhibber ◽  
Kenneth Fickling ◽  
Jeffrey W. Kolano ◽  
William A. Roberts
Keyword(s):  
Carbon Dioxide ◽  
Laryngeal Mask Airway ◽  
Endotracheal Tube ◽  
Laryngeal Mask ◽  
Arterial Carbon Dioxide ◽  
End Tidal

scholarly journals Laryngeal mask airway versus endotracheal tube for airway management during laparoscopic percutaneous extraperitoneal closure for inguinal hernia in pediatric day surgery: a retrospective analysis

2021 ◽  
Author(s):  
Tamaki Iwade ◽  
Koichi Ohno
Keyword(s):  
Carbon Dioxide ◽  
Inguinal Hernia ◽  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Endotracheal Tube ◽  
Bispectral Index ◽  
Laryngeal Mask ◽  
Group I ◽  
End Tidal Carbon Dioxide ◽  
End Tidal

Abstract BackgroundAlthough endotracheal tube is preferred for airway management during laparoscopic percutaneous extraperitoneal closure for inguinal hernias, laryngeal mask airway may also be used. However, few studies have reported the usefulness of laryngeal mask airway during laparoscopic percutaneous extraperitoneal closure. Our study aims to report the advantages of laryngeal mask airway versus endotracheal tube during laparoscopic percutaneous extraperitoneal closure for inguinal hernia in pediatric day surgery.MethodsThe records of 56 patients (Group I, endotracheal tube; Group II, laryngeal mask airway) treated for inguinal hernia using laparoscopic percutaneous extraperitoneal closure between November 2018 and December 2019 were retrospectively reviewed. The duration of anesthesia; changes in hemodynamics (heart rate and systolic/diastolic blood pressure), end-tidal carbon dioxide, and bispectral index; and postoperative complications were analyzed.ResultsGroups I and II had 39 and 17 patients, respectively. The duration of anesthesia and surgery and changes in hemodynamics and bispectral index were similar between the two groups. Induction and recovery times were significantly shorter and changes in end-tidal carbon dioxide were more significant in Group II (p < 0.05). The incidence of sore throat and nausea was higher in Group I (p < 0.05).ConclusionsLaryngeal mask airway was equivalent to endotracheal tube in terms of performance during laparoscopic percutaneous extraperitoneal closure, although induction and recovery were achieved sooner in laryngeal mask airway, with a lower incidence of sore throat and nausea.Trial RegistrationNot applicable

Comparison of End-Tidal and Arterial Carbon Dioxide in Infants Using Laryngeal Mask Airway and Endotracheal Tube

1997 ◽  
Vol 84 (1) ◽  
pp. 51-53 ◽  
Author(s):  
Ashwani K. Chhibber ◽  
Kenneth Fickling ◽  
Jeffrey W. Kolano ◽  
William A. Roberts
Keyword(s):  
Carbon Dioxide ◽  
Laryngeal Mask Airway ◽  
Endotracheal Tube ◽  
Laryngeal Mask ◽  
Arterial Carbon Dioxide ◽  
End Tidal

Laryngeal mask airway and tracheal tube insertion by unskilled personnel

1991 ◽  
Vol 77 (1) ◽  
pp. 21-25
Author(s):  
P. R. F. Davies ◽  
S. Q. M. Tighe ◽  
G. L. Greenslade ◽  
G. H. Evans
Keyword(s):  
Carbon Dioxide ◽  
Laryngeal Mask Airway ◽  
Tracheal Tube ◽  
Random Order ◽  
Training Programme ◽  
Laryngeal Mask ◽  
Tube Insertion ◽  
Airway Intervention ◽  
Lung Expansion ◽  
End Tidal

AbstractAfter a short training programme 11 naval medical trainees inserted a laryngeal mask airway (LMA) and a tracheal tube (ETT) in random order in a total of 110 anaesthetized patients. They were allowed 40 seconds for each attempt. Success was defined as the detection of expired carbon dioxide within 40 seconds of Guedel airway removal which subsequently rose to an end-tidal value of at least 4 kPa, together with satisfactory lung expansion and ventilation, without other airway intervention by the anaesthetist. One hundred and four LMA insertions were successful compared with 56 ETTs (p<0.01). All first attempts at LMA insertion were successful, whereas satisfactory ETT placement was progressive. Insertion was also quicker with the LMA (20 seconds) than with the ETT (35 seconds) (p<0.01). Further studies are indicated to assess the value of the LMA in emergencies.

Exercise end-tidal carbon dioxide pressure: a new prognostic marker after acute myocardial infarction?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
J Ferreira ◽  
P Rio ◽  
A Castelo ◽  
I Cardoso ◽  
S Silva ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Carbon Dioxide ◽  
Acute Myocardial Infarction ◽  
Prognostic Marker ◽  
Systolic Function ◽  
Prognostic Role ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Pressure ◽  
End Tidal ◽  
Maximal Effort

Abstract Funding Acknowledgements Type of funding sources: None. Background Although several cardiopulmonary exercise testing (CPET) parameters have already proved to predict prognosis, there is increasing interest in finding variables that do not require maximal effort. End-tidal carbon dioxide pressure (PETCO2), an indirect indicator of cardiac output, is one of such variables. Studies in heart failure populations already suggest its role as a prognostic factor. However, data concerning other populations are still scarce. Purpose To assess the association between exercise PETCO2, cardiac biomarkers and systolic function following acute myocardial infarction (AMI) and to evaluate its potential prognostic role in this population. Methods A retrospective single-centre analysis was conducted including patients who underwent symptom-limited CPET early after AMI. We assessed PETCO2 at baseline (PETCO2-B), at anaerobic threshold (PETCO2-AT) and at peak exercise and calculated the difference between PETCO2-AT and PETCO2-B (PETCO2-difference). We analysed their association with B-natriuretic peptide (BNP), maximal troponin after AMI as well as with left ventricular ejection fraction (LVEF) 1 year after. Results We included 40 patients with a mean age of 56 years (87.5% male), assessed with CPET a median of 3 months after AMI (80% of which were ST-elevation myocardial infarctions). Average respiratory exchange ratio was 1,1 with 48% of patients not reaching maximal effort. Mean PETCO2-AT was 37mmHg, with a mean increase from baseline of 6mmHg (PETCO2-difference). There was a significant positive correlation between all the PETCO2 variables measured and BNP values at time of AMI and on follow-up (best correlation for PETCO2-AT with BNP at AMI hospitalization, r = 0.608, p &lt; 0.001). Maximal troponin was not correlated with PETCO2. Both PETCO2-AT and PETCO2-difference were significantly and positively correlated with LVEF 1-year post-AMI (r = 0.421, p = 0.040 and r = 0.511, p = 0.011, respectively). Conclusion PETCO2-AT and PETCO2-difference are both correlated with BNP, an established prognostic marker, and with medium-term systolic function after AMI, suggesting their potential prognostic role in this population. Further studies with larger samples are required to confirm the results of this pilot study and assess PETCO2 as a definite predictor of prognosis after AMI.

scholarly journals Second-generation laryngeal mask airway as an alternative to endotracheal tube during prolonged laparoscopic abdominal surgery: a comparative analysis of intraoperative gas exchanges

2021 ◽  
Author(s):  
S Park ◽  
JE Lee ◽  
GS Choi ◽  
JM Kim ◽  
JS Ko ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Gas Exchange ◽  
Laryngeal Mask Airway ◽  
Abdominal Surgery ◽  
Partial Pressure ◽  
Endotracheal Tube ◽  
Second Generation ◽  
Laryngeal Mask ◽  
Arterial Partial Pressure ◽  
Prolonged Surgery

Introduction: Despite several advantages over endotracheal tube (ETT), laryngeal mask airway (LMA), which is used in emergencies under difficult airway maintenance conditions, is rarely utilized in prolonged surgery. We compared the variables representing intraoperative gas exchange with second-generation LMA and ETT during prolonged laparoscopic abdominal surgery. Methods: Prolonged surgery was defined as a surgery lasting more than 2 h. In total, 394 patients who underwent laparoscopic liver resection via either second-generation LMA or ETT were retrospectively analysed. Parameters including end-tidal pressure of carbon dioxide (ETCO2), tidal volume (TV), respiratory rate (RR), peak inspiratory pressure (PIP), arterial partial pressure of carbon dioxide (PaCO2), pH, and ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PFR) during surgery were compared between the two groups. In addition, the incidence of postoperative pulmonary complications (PPC) including pulmonary aspiration was also compared. Results: The values of ETCO2, TV, RR and PIP during pneumoperitoneum were comparable between the two groups. Although PaCO2 at 2 h after induction was higher in patients with LMA (40.5 vs. 38.5 mmHg, p < 0.001), the pH and PFR values of the two groups were comparable. The incidence of PPC was not different. Conclusion: During prolonged laparoscopic abdominal surgery, the second-generation LMA facilitates adequate intraoperative gas exchange and represents an alternative to ETT.

scholarly journals Accuracy of Postoperative End-tidal Pco2Measurements with Mainstream and Sidestream Capnography in Non-obese Patients and in Obese Patients with and without Obstructive Sleep Apnea

2009 ◽  
Vol 111 (3) ◽  
pp. 609-615 ◽  
Author(s):  
Yusuke Kasuya ◽  
Ozan Akça ◽  
Daniel I. Sessler ◽  
Makoto Ozaki ◽  
Ryu Komatsu
Keyword(s):  
Carbon Dioxide ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Cannula ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Pressure ◽  
End Tidal

Background Obtaining accurate end-tidal carbon dioxide pressure measurements via nasal cannula poses difficulties in postanesthesia patients who are mouth breathers, including those who are obese and those with obstructive sleep apnea (OSA); a nasal cannula with an oral guide may improve measurement accuracy in these patients. The authors evaluated the accuracy of a mainstream capnometer with an oral guide nasal cannula and a sidestream capnometer with a nasal cannula that did or did not incorporate an oral guide in spontaneously breathing non-obese patients and obese patients with and without OSA during recovery from general anesthesia. Methods The study enrolled 20 non-obese patients (body mass index less than 30 kg/m) without OSA, 20 obese patients (body mass index greater than 35 kg/m) without OSA, and 20 obese patients with OSA. End-tidal carbon dioxide pressure was measured by using three capnometer/cannula combinations (oxygen at 4 l/min): (1) a mainstream capnometer with oral guide nasal cannula, (2) a sidestream capnometer with a nasal cannula that included an oral guide, and (3) a sidestream capnometer with a standard nasal cannula. Arterial carbon dioxide partial pressure was determined simultaneously. The major outcome was the arterial-to-end-tidal partial pressure difference with each combination. Results In non-obese patients, arterial-to-end-tidal pressure difference was 3.0 +/- 2.6 (mean +/- SD) mmHg with the mainstream capnometer, 4.9 +/- 2.3 mmHg with the sidestream capnometer and oral guide cannula, and 7.1 +/- 3.5 mmHg with the sidestream capnometer and a standard cannula (P &lt; 0.05). In obese non-OSA patients, it was 3.9 +/- 2.6 mmHg, 6.4 +/- 3.1 mmHg, and 8.1 +/- 5.0 mmHg, respectively (P &lt; 0.05). In obese OSA patients, it was 4.0 +/- 3.1 mmHg, 6.3 +/- 3.2 mmHg, and 8.3 +/- 4.6 mmHg, respectively (P &lt; 0.05). Conclusions Mainstream capnometry performed best, and an oral guide improved the performance of sidestream capnometry. Accuracy in non-obese and obese patients, with and without OSA, was similar.

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