To evaluate the use of ProSeal laryngeal mask airway in patients undergoing elective lower segment cesarean section under general anesthesia: A prospective randomized controlled study

Abstract BackgroundOptimal size selection of classic laryngeal mask airway (LMA) remains a major challenge for anaesthesiologists. Because the body weight, current method to select LMA size, might not inconsistent with dimension of hypopharynx where LMA is positioned. Hyomental distance by ultrasound as an common parameter in upper airway may be considered a predictor of LMA size choice, that we conducted a randomized, controlled study to compare the efficacy of size selection between commonly recommended weight-based method and hyomental distance-based method.MethodsSeventy female patients undergoing breast cancer surgery were enrolled in our study and randomly assigned into either the hyomental distance group or weight group. The primary outcome was the correct rate of selection LMA without need for size adjustment or use of other devices. Secondary outcomes included injury rate, oropharyngeal leak pressure (OLP), and insertion attempts.ResultsTwo participants were excluded from weight group due to tracheal intubation. The correct rate of LMA size-selected were significant difference of 77.14% and 51.51% in hyomental distance group and weight group, respectively(P=0.027). Five (14.29%) and 7 (21.21%) patients were injured in hyomental-distance group and weight group, respectively. Values of OLP in two groups were 22 (19-24) cmH2O and 22 (19.5-24) cmH2O, respectively. The insertion attempts were the same in both groups and no statistical differences were observed regarding these three outcomes. ConclusionThe hyomental distance-based method possessed a higher success rate for LMA-classic size selection than did the weight-based method, with the same excellent OLP value, low possibility of injury, and a low number of insertion attempts as weight-based method. Trial registrationOur study was registered with the Chinese Clinical Trial Registry (ChiCTR1900021123), registered 29 January 2019.

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Use of the bronchial blocker via laryngeal mask airway for one-lung ventilation in children undergoing thoracoscopic surgery: a randomized controlled study.

10.22541/au.160139711.19979243 ◽

2020 ◽

Author(s):

XH Cao ◽

Wangping Zhang ◽

L Huang ◽

ZY Hu

Keyword(s):

Laryngeal Mask Airway ◽

Thoracoscopic Surgery ◽

Lung Ventilation ◽

Laryngeal Mask ◽

Randomized Controlled Study ◽

Bronchial Blocker ◽

Controlled Study ◽

One Lung Ventilation ◽

Randomized Controlled

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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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