scholarly journals Comparison of Clinical Performance of Supraglottic Airway Devices in Elderly Patients: A Prospective Randomized Trial

2021 ◽  
Author(s):  
Reyhan Polat ◽  
Sibel Çatalca ◽  
Julide Ergil ◽  
İlkay Baran ◽  
Aylin Tamam ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Clinical Performance ◽  
The Elderly ◽  
Supraglottic Airway ◽  
Positive Pressure ◽  
Success Rates ◽  
Group I ◽  
Supraglottic Airway Devices ◽  
Significant Difference ◽  
Airway Devices

INTRODUCTION: Airway management in the elderly may be challenging. Supraglottic airway devices (SADs) may be used to provide airway security. The aim of study was to compare the efficacy and safety of different SADs, LMA classic (c-LMA), proseal LMA (p-LMA) and i-gel in anaesthetised and non-paralysed elderly patients. METHODS: The study was approved by a local ethics committee. Eighty patients, aged older than 65 years, who were scheduled to undergo elective urological or orthopaedic surgery participated in the study. Each patient was randomly allocated into 1 of 3 groups: Group C: c-LMA (n = 26), Group P: p-LMA (n = 27) or Group I: i-gel (n = 27). The primary outcome was oropharyngeal sealing pressure (OSP). Secondary outcomes included the adequacy of positive pressure ventilation, ease of insertion, success rates, time to insertion, haemodynamic response and complications such as sore throat and dysphagia. RESULTS: There were no significant differences among the groups with respect to OSP (p=0.852), whereas there was a statistically significant difference between Group I and Group C in terms of leak volume and leak fraction ( p= 0.042 and p = 0.020, respectively ). Adverse events were similar among the groups (p > 0.05). DISCUSSION AND CONCLUSION: In this study, although the leak volume and leak fraction were lower in i-gel inserted patients, it was shown that i-gel, c-LMA and p-LMA provided adequate airway in elderly patients who were not applied muscle relaxants and will be operated under general anesthesia.

scholarly journals A comparison of two supraglottic airway devices in general anaesthesia: baska mask® vs. I-gel®

2019 ◽  
Vol 6 (12) ◽  
pp. 333-339
Author(s):  
Özlem Sezen
Keyword(s):  
General Anaesthesia ◽  
Sore Throat ◽  
Clinical Performance ◽  
Insertion Time ◽  
Supraglottic Airway ◽  
Peripheral Oxygen Saturation ◽  
Supraglottic Airway Devices ◽  
Gastric Regurgitation ◽  
Significant Difference ◽  
Airway Devices

Objective: The aim of this was to compare the Baska® mask and the I-gel® airway in paralyzed patients during general anaesthesia in terms of clinical performance, the risk of aspiration, and intraoperative and postoperative characteristics. Material and Methods: The two devices were compared in 100 paralyzed anesthetized adult patients. Primary outcomes of the study were to evaluate the characteristics of the airway devices within respect to the success of first insertion attempt, the insertion time, the ease of insertion, leak volume, and peak airway pressure. The blood staining on the mask, and the presence of gastric reflux or sore throat two hours postoperatively were evaluated. Hemodynamics, end-tidal CO2 and the peripheral oxygen saturation measurements were secondary outcomes. Results: No statistically significant difference was observed between the groups in the criteria of first attempt success rate, ease of insertion, blood staining upon removal of the masks, gastric regurgitation, or sore throat two hours after the procedure. The insertion time was significantly longer for the Baska® mask compared with the I-gel® airway. The leak volume was significantly higher in the Baska® mask patients throughout the surgical procedure. The heart rate and mean arterial pressure measurements were significantly higher in the Baska® mask patients. Conclusions: Both the Baska® mask and the I-gel ® device can be used effectively for selected paralyzed patients under general anaesthesia. The insertion time was significantly longer for the Baska® mask compared with the I-gel® device.

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

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.

scholarly journals Impact of a semi-structured briefing on the management of adverse events in anesthesiology: A randomized pilot study.

2019 ◽  
Author(s):  
Christopher Neuhaus ◽  
Johannes Schäfer ◽  
Markus A. Weigand ◽  
Christoph Lichtenstern
Keyword(s):  
Rapid Sequence Induction ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Anesthesia Induction ◽  
Team Members ◽  
Rapid Sequence ◽  
Supraglottic Airway Devices ◽  
Significant Difference ◽  
Alternative Means ◽  
Airway Devices

Abstract Background : Human factors research has identified mental models as a key component for the effective sharing and organization of knowledge. The challenge lies in the development and application of tools that help team members to arrive at a shared understanding of a situation. The aim of this study was to assess the influence of a semi-structured briefing on the management of a simulated airway emergency. Methods : 37 interprofessional teams were asked to perform a simulated rapid-sequence induction in the simulator. Teams were presented with a “cannot ventilate, cannot oxygenate” scenario that ultimately required a cricothyroidotomy. Study group (SG) teams were asked to perform a briefing prior to induction, while controls (CG) were asked to perform their usual routine. Results : We observed no difference in the mean time until cricothyroidotomy (SG 8:31 CG 8:16, p=0.36). There was a significant difference in groups’ choice of alternative means of oxygenation: While SG teams primarily chose supraglottic airway devices, controls initially reverted to mask ventilation (p=0.005). SG teams spent significantly less time with this alternative airway device and were quicker to advance in the airway algorithm. Conclusions : Our study addresses effects on team coordination through a shared mental model as effected by a briefing prior to anesthesia induction. We found measurable improvements in airway management during those stages of the difficult airway algorithm explicitly discussed in the briefing. For those, time spent was shorter and participants were quicker to advance in the airway algorithm.

scholarly journals A comparative study between i-gel and classical laryngeal mask airway in elective surgery under general anaesthesia

2016 ◽  
Vol 2 (9) ◽  
pp. 227
Author(s):  
Smita R. Engineer ◽  
Digant B. Jansari ◽  
Saumya Saxena ◽  
Rahul D. Patel
Keyword(s):  
Laryngeal Mask Airway ◽  
General Anesthesia ◽  
Elective Surgery ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Hemodynamic Parameters ◽  
Randomized Clinical Study ◽  
Group I ◽  
Supraglottic Airway Devices ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> Supraglottic airway devices have been widely used as an alternative to tracheal intubation during general anesthesia both in adults and children. This study was carried out to compare classical laryngeal mask airway (LMA) and i-gel, regarding ease of insertion, adequate placement of device, ability to maintain ETCO<sub>2</sub> and SPO<sub>2</sub>, perioperative hemodynamic parameters and intra operative and postoperative complication.</p><p class="abstract"><strong>Methods:</strong> This prospective, randomized clinical study was done on 100 patients of either sex, age between 5 to 60 years, ASA grade I-III who underwent different surgical procedures under general anesthesia in supine position. After giving premedication, induction of anesthesia was done with inj. Propofol 2-3 mg/kg and inj. Succnylcoline 1.5-2 mg/kg. In “sniffing air” position, airway was secured with either LMA or i-gel. An effective placement of device was checked by a square wave capnography, normal chest expansion, SPO<sub>2</sub> &gt;95%, and absence of audible leak. Patients were observed for time and ease of insertion, number of attempts, perioperative hemodynamic changes and complications.</p><p><strong>Results:</strong> No statistically significant difference was reported between both the groups, regarding heart rate, BP, SPO<sub>2</sub> and ETCO<sub>2</sub>. Duration of insertion was more in group LMA. Insertion was easy and was possible in first attempt in 88% of patients without much manipulation in group i-gel.</p><p><strong>Conclusions:</strong> I-gel is a better alternative supraglottic airway device than LMA in view of ease of insertion with minimal manipulations and minimal complications. Hemodynamic parameters, SPO<sub>2</sub> and ETCO<sub>2 </sub>were maintained in both the groups. </p>

scholarly journals Comparison of Safety and Efficacy of Endotracheal Tube, Laryngeal Mask Airway Supreme and I Gel in Laparoscopic Surgeries

2021 ◽  
Vol 8 (11) ◽  
pp. 623-628
Author(s):  
Heena Saini ◽  
Rajesh Angral ◽  
Neelam Gupta
Keyword(s):  
Laryngeal Mask Airway ◽  
Endotracheal Tube ◽  
Gastric Tube ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Group I ◽  
Supraglottic Airway Devices ◽  
Lma Supreme ◽  
Airway Devices

BACKGROUND Present study was undertaken to assess the feasibility of laryngeal mask airway (LMA) supreme and I gel, the second generation supraglottic airway devices in laparoscopic surgeries. METHODS 120 patients with American Society of Anaesthesiologists (ASA) I and II (20 - 50 years) of either sex who underwent laparoscopic surgery under general anaesthesia were randomly divided into three groups. Airway was secured with endotracheal tube (ETT) in group E (N = 40), with LMA supreme in Group S (N = 40) and with I-gel in group I (N = 40). Insertion characteristics of airway device, ease of gastric tube insertion, haemodynamic response and perioperative laryngopharyngeal morbidities were assessed. RESULTS I-gel was easier to insert with higher first attempt success rate (95 %) than LMA Supreme (85 %) and ETT (90 %) but it was statistically insignificant. Heart rate (HR) and mean arterial pressure (MAP) was significantly higher in ETT group at the time of intubation, continued till 5 minutes and also at the time of extubation but statistically significant increase in HR and MAP were noted in group S and I only at the time of device insertion. Gastric tube was easier to insert in group S with shortest insertion time which was statistically significant. Incidence of coughing, dysphonia, dysphagia and sore throat was significantly more in group E. CONCLUSIONS I-gel and LMA Supreme can be used as an alternative to ETT for airway management in adult patients undergoing elective laparoscopic surgeries. KEYWORDS Endotracheal Tube, I-gel, LMA Supreme, Supraglottic Airway Device

Getting started

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.

scholarly journals Impact of a semi-structured briefing on the management of adverse events in anesthesiology: a randomized pilot study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Christopher Neuhaus ◽  
Johannes Schäfer ◽  
Markus A. Weigand ◽  
Christoph Lichtenstern
Keyword(s):  
Rapid Sequence Induction ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Anesthesia Induction ◽  
Team Members ◽  
Rapid Sequence ◽  
Supraglottic Airway Devices ◽  
Significant Difference ◽  
Alternative Means ◽  
Airway Devices

Abstract Background Human factors research has identified mental models as a key component for the effective sharing and organization of knowledge. The challenge lies in the development and application of tools that help team members to arrive at a shared understanding of a situation. The aim of this study was to assess the influence of a semi-structured briefing on the management of a simulated airway emergency. Methods 37 interprofessional teams were asked to perform a simulated rapid-sequence induction in the simulator. Teams were presented with a “cannot ventilate, cannot oxygenate” scenario that ultimately required a cricothyroidotomy. Study group (SG) teams were asked to perform a briefing prior to induction, while controls (CG) were asked to perform their usual routine. Results We observed no difference in the mean time until cricothyroidotomy (SG 8:31 CG 8:16, p = 0.36). There was a significant difference in groups’ choice of alternative means of oxygenation: While SG teams primarily chose supraglottic airway devices, controls initially reverted to mask ventilation (p = 0.005). SG teams spent significantly less time with this alternative airway device and were quicker to advance in the airway algorithm. Conclusions Our study addresses effects on team coordination through a shared mental model as effected by a briefing prior to anesthesia induction. We found measurable improvements in airway management during those stages of the difficult airway algorithm explicitly discussed in the briefing. For those, time spent was shorter and participants were quicker to advance in the airway algorithm.

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