Airway Management In Pediatric Anesthesia: Laryngeal Mask Airway Vs Endotracheal Tube

10.5580/1289 ◽  
2007 ◽  
Vol 13 (1) ◽  
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Endotracheal Tube ◽  
Pediatric Anesthesia ◽  
Laryngeal Mask

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

An Airway Management Device: The Laryngeal Mask Airway—A Review

1998 ◽  
Vol 13 (1) ◽  
pp. 32-43 ◽  
Author(s):  
Clifford A. Schmiesing ◽  
John G. Brock-Utne
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Endotracheal Tube ◽  
Face Mask ◽  
Laryngeal Mask ◽  
Emergency Airway ◽  
Oral Airway ◽  
Accepted Part ◽  
Airway Devices ◽  
New Generation

The laryngeal mask airway (LMA) is an airway management device that has become an accepted part of anesthetic practice in both pediatric and adults surgical patients. It is inserted without the use of a laryngoscope or muscle relaxants into the hypopharynx forming a low pressure seal around the glottis. The LMA provides a better airway than a face mask with or without an oral airway. Insertion techniques are quickly learned and are described in this review. Since the LMA forms a less secure seal than an endotracheal tube (ETT), several important limitations and contraindications exist. This includes patients at high risk for regurgitation of gastric contents into the lungs causing pulmonary aspiration and patients requiring high ventilatory pressures or prolonged ventilation. These contraindications have limited its introduction and utilization in the intensive care unit (ICU). The LMA is a helpful tool in the management of both the expected and unexpected difficult airway, where it may serve both as an emergency airway and as a conduit to intubation of the trachea with an ETT over a fiberoptic bronchoscope (FOB) or gum elastic bougie. A lifesaving airway has been provided by the LMA where no other means of achieving ventilation were possible in patients, including neonates, trauma victims, woman undergoing cesarean section, and in the setting of cardiac arrest. There are very few reported uses of the LMA in the ICU. We believe that familiarity with the LMA's design, use, and limitations by critical care practitioners will increase its use in emergency airway management and in the ICU. The LMA may prove to be the first of a new generation of airway devices placed into the hypopharynx to provide an alternative to the endotracheal tube and mask airway.

scholarly journals Cluster cross-over randomised trial of paediatric airway management devices in the simulation lab and operating room among paramedic students

2020 ◽  
Vol 38 (1) ◽  
pp. 27-32
Author(s):  
Matthew Lee Hansen ◽  
Adam Wagner ◽  
Ashley Schnapp ◽  
Amber Lin ◽  
Nancy Le ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Endotracheal Tube ◽  
Operating Room ◽  
Randomised Trial ◽  
Multivariable Analysis ◽  
Random Order ◽  
Laryngeal Mask ◽  
Significant Difference ◽  
Mean Time

ObjectivesThe objective of this study was to compare paediatric emergency airway management strategies in the simulation lab and operating room environments.MethodsThis was a two-part cluster cross-over randomised trial including simulation lab and operating room environments conducted between January 2017 and June 2018 in Portland, Oregon, USA. In simulated infant cardiac arrests, paramedic students placed an endotracheal tube, an i-gel or a laryngeal mask airway in random order. In the operating room, paramedic students placed a laryngeal mask airway or i-gel device in random order in sequential patients. The primary outcome for both portions of the study was time to ventilation. In the operating room portion, we also evaluated leak pressures and average initial tidal volumes.ResultsThere were 58 paramedic students who participated in the simulation lab and 22 who participated in the operating room study. The mean time to airway placement in the simulation lab was 48.5 s for the i-gel, 68.9 s for the laryngeal mask and 129.5 s for the endotracheal tube. In the operating room, mean time to i-gel placement was 34.3 s with 45.2 s for the laryngeal mask. In multivariable analysis of the simulation study, the laryngeal mask and i-gel were significantly faster than the endotracheal tube, and the i-gel was faster than the laryngeal mask. In the operating room, there was no significant difference in time to placement, leak pressure and average volume of the first five breaths between the i-gel and laryngeal mask.ConclusionsWe found that paramedic students were able to place supraglottic devices rapidly with high success rates in simulation lab and operating room environments. Supraglottic devices, particularly the i-gel, were rated as easy to use. The i-gel may be easiest to use since it lacks an inflable cuff and requires fewer steps to place.

scholarly journals Comparison of the Skill of Emergency Medical Technicians in Terms of Advanced Airway Management Using Endotracheal Tube vs Laryngeal Mask Airway in an OSCE Using a Mannequin

2020 ◽  
Author(s):  
Peyman Saberian ◽  
Ehsan Karimialavijeh ◽  
Mostafa Sadeghi ◽  
Mojgan Rahimi ◽  
Parisa Hasani-Sharamin ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Emergency Medical ◽  
Advanced Airway ◽  
Significant Difference ◽  
The Mean

Background: Supraglottic airway management tools such as the laryngeal mask airway (LMA) have recently emerged as the first choice in pre-hospital and hospital airway management guidelines as well as an alternative strategy after endotracheal tube (ETT) placement failure. However, the pros and cons of the LMA compared to endotracheal intubation are still debated. Given that no study has been conducted to date on the skills of emergency medical technician (EMT) in airway management using LMA compared to endotracheal intubation, we decided to do a study in this regard. Methods: In this objective structured clinical examination (OSCE), EMTs who had a degree of associate or bachelor were participated. The examiner asked the examinees the required information and entered it in the pre-prepared checklists. The participants took part in a two-stage exam. In the first stage, the airway management of the simulated trauma patient was performed by endotracheal intubation, and in the second stage, the same scenario was performed with LMA. At each stage, the examiner evaluated the examinee's performance in 4 fields of Preparation, Pre-oxygenation, Position and Placement, and Post-intubation management using a standard checklist. In addition, the duration of the procedure from the beginning to the time of fixing the ETT or LMA was recorded and compared. Results: Totally, 105 EMTs participated in this study, of whom, 102 were male (97.1%). The mean age of the subjects was 36.4± 7.3 years old. Of the total participants, 72 passed both practical exams successfully, and they generally insert the LMA faster; so that the duration of intubation and LMA insertion in 1.4% and 30.6% were <1 min, respectively (p< 0.001). However, no significant difference was observed in terms of the mean time (p= 0.427). Conclusion: In the present study, the skills of the technicians participating in the study in performing advanced airway procedures were moderate, and also, it was found that their skills in LMA insertion were less than endotracheal tube insertion.

Sign in / Sign up

Export Citation Format

Share Document