Clinical assessment of the efficacy of supraglottic airway devices compared with endotracheal tubes in cats during volume-controlled ventilation

Background: A fear of potential gas leak limits the wide spread use of minimal flow anesthesia with supraglottic airway devices. Second generation supraglottic airway devices have been claimed to be come with good airway seal. I-gel is one of these and it has been extensively evaluated for spontaneous as well as assisted ventilation. We conducted this study to evaluate its use with low flow anesthesia and volume controlled ventilation. Methodology: In a prospective randomized controlled trial, 50 patients undergoing laparoscopic surgeries for less than 2 h duration were administered general anesthesia, with controlled ventilation, using either endotracheal tube or an I-gel for airway control. The total fresh gas flow was gradually reduced until it was 400 mL/min. Patients were monitored for evidence of loss of respiratory gas volume in the breathing circuit and other parameters for ventilation failure. Results: Ventilation could be maintained at a fresh gas flow of 400 mL/min, without clinical or volumetric evidence of gas leak in all patients in the two groups. Two patients in the I-gel group had intraoperative gas leak leading to ventilator failure alarm but the same was corrected by repositioning of the head. The vital signs, peak airway pressure, end-tidal carbon dioxide, set tidal volume and expired tidal volumes were statistically similar in the two groups. Conclusion: I-gel supraglottic airway can be safely and efficiently used for laparoscopic surgery using minimal flow anesthesia and volume controlled ventilation. Citation: Khan A, Kapoor MC, Garg S, Puri A, Sinha A. I-gel supraglottic airway use is efficient and safe during minimal flow anesthesia with volume controlled ventilation - a randomized controlled trial. Anaesth pain intensive care 2020;24(1):__ Abbreviations: Supraglottic airway device – SAD; Volume controlled ventilation – VCV; Pressure controlled ventilation – PCV; Endotracheal tube – ETT; Laryngeal Mask Airway - LMA DOI: https://doi.org/10.35975/apic.v24i1. Received – 11 June 2019; Reviewed – 20, 23 October 2019; Revised – 31 January 2020; Second Review – 2, 7 January 2020; Accepted – 02 February 2020;

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Anaesthetic equipment

Paediatric Anaesthesia ◽

10.1093/med/9780198755791.003.0005 ◽

2019 ◽

pp. 71-100

Author(s):

Richard Craig

Keyword(s):

Near Infrared ◽

Supraglottic Airway ◽

Endotracheal Tubes ◽

Practical Advice ◽

Anaesthetic Equipment ◽

Supraglottic Airway Devices ◽

Perioperative Monitoring ◽

Airway Equipment ◽

Bis Monitor ◽

Airway Devices

This chapter presents anaesthetic equipment used in paediatric anaesthesia. Airway equipment is described in detail with specific examples. This includes a description of the variety of supraglottic airway devices, endotracheal tubes, laryngoscopes for direct and indirect visualization of the larynx, breathing systems, ventilators, and modes of ventilation. Equipment for perioperative monitoring of the paediatric patient is reviewed. Practical advice regarding monitoring neonates and small babies is given particular attention. The use of the bispectral index (BIS) monitor and near-infrared spectroscopy (NIRS) are discussed. New advances in pulse oximetry that enable better monitoring with low perfusion states and motion are included.

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Bi-national survey of intraoperative cuff pressure monitoring of endotracheal tubes and supraglottic airway devices in operating theatres

Anaesthesia and Intensive Care ◽

10.1177/0310057x19850581 ◽

2019 ◽

Vol 47 (4) ◽

pp. 378-384 ◽

Cited By ~ 1

Author(s):

Julie Lee ◽

Heather Reynolds ◽

Anita M Pelecanos ◽

André AJ van Zundert

Keyword(s):

New Zealand ◽

Cuff Pressure ◽

Public Hospitals ◽

Supraglottic Airway ◽

Intracuff Pressure ◽

Pressure Monitoring ◽

Endotracheal Tubes ◽

Supraglottic Airway Devices ◽

Zealand College ◽

Airway Devices

Correct intracuff pressure of endotracheal tubes and supraglottic airway devices is required to avoid complications such as sore throat, dysphagia and dysphonia, while maintaining an adequate airway seal. However, intracuff pressure monitoring of airway devices during general anaesthesia may not receive the attention it deserves. The aim of this survey was to investigate the current practice regarding intraoperative cuff pressure monitoring in hospitals across Australia and New Zealand. An online ten-question survey was disseminated by the Australian and New Zealand College of Anaesthetists Clinical Trials Network to a randomised selection of 1000 Australian and New Zealand College of Anaesthetists Fellows working in private and public hospitals of varying sizes. There were 305 respondents in total, but not all respondents answered all questions. In total, 67 of 304 respondents (22.0%) did not have access to a cuff pressure manometer at their main site of work, and of these, 30 (9.9%) expressed that they would like access to one in their daily practice. Of 288 respondents, 122 (40.0%) reported that they used cuff pressure monitoring as part of their routine practice, but 95 (33.0%) measured the cuff pressure at induction only. For supraglottic airway devices, only 44 of 250 respondents (17.6%) aimed for a cuff pressure of 40–60 cmH2O. Of 255 respondents, 101 (39.6%) aimed for a cuff pressure of 20–30 cmH2O for endotracheal tubes. These findings indicate that educational programmes are required to increase the availability and use of cuff pressure monitoring devices for both endotracheal tubes and supraglottic airway devices across Australia and New Zealand.

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Comparison of the CobraPLA and the LMA Classic airway devices during volume-controlled ventilation in children

Korean Journal of Anesthesiology ◽

10.4097/kjae.2008.55.2.145 ◽

2008 ◽

Vol 55 (2) ◽

pp. 145 ◽

Cited By ~ 1

Author(s):

Chan Jong Chung ◽

Kyu Han Lee ◽

So Ron Choi ◽

Dae Cheol Kim ◽

Seung Cheol Lee

Keyword(s):

Controlled Ventilation ◽

Volume Controlled Ventilation ◽

Airway Devices ◽

Volume Controlled

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A Randomised comparison and evaluation of I-gel, Supreme laryngeal mask airway and Ambu Auragain in Laparoscopic surgeries under general anaesthesia with controlled ventilation

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i4.32931 ◽

2021 ◽

Vol 12 (4) ◽

pp. 68-75

Author(s):

Meenakshi Sumadevi Pradeep ◽

Niteen Khanderao Nandanwankar ◽

Priya Vishwanath Lahane ◽

Nazima Yusuf Memon ◽

Shridhar Devidas Yennawar ◽

...

Keyword(s):

General Anaesthesia ◽

Primary Outcome ◽

Supraglottic Airway ◽

Randomised Study ◽

Controlled Ventilation ◽

Group I ◽

Supraglottic Airway Devices ◽

Significant Difference ◽

Group A ◽

Airway Devices

Background: Supraglottic airway devices (SAD) are becoming increasingly popular for use in patients undergoing laparoscopic surgeries. In this prospective randomised study, we compared three supraglottic airway devices namely, I-gel, Supreme LMA and Ambu Auragain. Aims and Objectives: The study was undertaken to compare three supraglottic airway devices I-gel, Supreme LMA and Ambu Auragain in laparoscopic surgeries under general anaesthesia with controlled ventilation. Materials and Methods: This was a randomized comparative study in which 90 patients undergoing laparoscopic surgeries under general anesthesia were included. In group A Ambu AuraGain was used whereas in group I and Group S I-gel and Supreme LMA was used respectively. Primary outcome measures which were compared amongst the studied groups included time taken for insertion, ease of insertion, attempts required for insertion, ease of insertion of Ryles tube, fiberoptic bronchoscopic grading and Oropharyngeal leak pressure. Results: There was highly significant difference in the time taken for insertion of SAD in Group-A when compared to Group- I (p<0.0001) and Group-S (p<0.0001). Group-A had significantly increased grades of ease of insertion of SAD when compared to Group-I (p=0.04) and Group-S (p=0.004). 16.66% of patients in Group-A required 3 attempts for successful insertion of the SAD, while no patients in Group- I or Group A required more than two attempts for insertion(p<0.05). Conclusion: Ambu AuraGain provides better oropharyngeal seal and has higher leak pressures as compared to I-gel and Supreme LMA with similar hemodynamic stability and post-operative outcome makingit a preferable SAD over I-gel and Supreme LMA.

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Getting started

10.1093/med/9780198853053.003.0014 ◽

2021 ◽

pp. 343-360

Author(s):

Mincho Marroquin-Harris

Keyword(s):

Venous Access ◽

Anaesthetic Machine ◽

Supraglottic Airway ◽

Positive Pressure ◽

Endotracheal Tubes ◽

Supraglottic Airway Devices ◽

Anaesthetic Gases ◽

Airway Equipment ◽

Airway Devices

This chapter provides a basic overview of anaesthetic equipment and its safe use. Topics include the provision of anaesthetic gases, the basic components of the anaesthetic machine, breathing systems, positive-pressure ventilation, and airway equipment including laryngoscopes, endotracheal tubes and supraglottic airway devices. Methods of long-term venous access are discussed.

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