Preliminary evaluation of SaCoVLM™ video laryngeal mask airway in airway management for general anesthesia

Background To preliminary evaluate the application of SaCoVLM™ video laryngeal mask airway in airway management of general anesthesia. Methods We recruited 100 adult patients (ages 18–78 years, male 19, female 81, weight 48–90 kg) with normal predicted airway (Mallampati I ~ II, unrestricted mouth opening, normal head and neck mobility) and ASA I-II who required general anaesthesia. The SaCoVLM™ was inserted after anesthesia induction and connected with the anesthesia machine for ventilation. Our primary outcome was glottic visualization grades. Secondary outcomes included seal pressure, success rate of insertion, intraoperative findings (gastric reflux and contraposition), gastric drainage and 24-h complications after operation. Results The laryngeal inlet was exposed in all the patients and shown on the video after SaCoVLM™ insertion. The status of glottic visualization was classified: grade 1 in 55 cases, grade 2 in 23 cases, grade 3 in 14 cases and grade 4 in 8 cases. The first-time success rate of SaCoVLM™ insertion was 95% (95% CI = 0.887 to 0.984), and the total success rate was 96% (95% CI = 0.901 to 0.989). The sealing pressure of SaCoVLM™ was 34.1 ± 6.2 cmH2O and the gastric drainage were smooth. Only a small number of patients developed mild complications after SaCoVLM™ was removed (such as blood stains on SaCoVLM™ and sore throat). Conclusions The SaCoVLM™ can visualize partial or whole laryngeal inlets during the surgery, with a high success rate, a high sealing pressure and smooth gastroesophageal drainage. SaCoVLM™ could be a promise new effective supraglottic device to airway management during general anesthesia. Trial registration ChiCTR,ChiCTR2000028802.Registered 4 January 2020.

To compare the frequency of postoperative sore throat with I-gel versus laryngeal mask airway in patients

Background: In case of general anesthesia, airway maintenance along with least complications is the most important goal of team of anesthesiologists. In case of clinical practice, the laryngeal mask airway (LMA) devices have superiority in managing supraglottic airway. Recently i-gel airway has been introduced as supraglottic airway equipment (disposable). Aim: To make comparison between laryngeal mask and I-gel with respect to postoperative complication of sore throat in case of patients who were given general anesthesia. Study design: Randomized trial Setting: Anesthesia Department Study duration: 6 after synopsis approval in total 6months of duration Methods: Candidates were divided randomly divided into two groups. In case of members of group A, patients were given i-gel where as members of group B, disposable LMA was given. General anesthesia was administered according to the standardized protocols. A day after operation, candidates were check post operatively for 24 hours, for sore throat and information was documented on Performa. Results: The candidates mean age was 44.23±15.11years in case of i-gel group members whereas 46.10±15.56 years in case of LMA group. In case of i-gel group, there were about twenty five males members and thirty five were females members . In case of LMA group members, there were about twenty six males and thirty four female members . In present case research, sore throat postoperatively was seen in case of 17(14.2%) cases, i.e. 4 (6.7%) in i-gel group while 13(21.7%) in case of LMA group. The significant difference was witnessed between members of both groups (p<0.05). Conclusion: Thus i-gel is better than LMA for general anesthesia as it has fewer chances of side effects like postoperative sore throat. Keywords: Postoperative sore throat, I-gel, laryngeal mask airway, general anesthesia

Comparison of Frequency of Complications of i-Gel and Laryngeal Mask Airway Supreme™ in Laparoscopic Cholecystectomy

Aim: To compare the frequency of complications of i-gel versus laryngeal mask airway supreme™ (LMA Supreme) in laparoscopic cholecystectomy. Study Design: Randomized Controlled Trial Place and Duration of Study: Department of Anesthesia, Jinnah Postgraduate Medical Institute Karachi from 16th September 2019 to 15th March 2020. Methodology: One hundred and fifty four patients having gallstones ≤5 in numbers (size <2cm) on ultrasound for >6 months requiring cholecystectomy and planned for elective list under general anesthesia of age ranges from 25-55 years of both gender were included. Patients with known or predicted difficult airway, oropharyngeal pathology, cervical spine fracture, GERD and hiatus hernia were excluded. In group A, airway was secured with i-gel while in group B, airway was secured with laryngeal mask airway supreme™. In all patients, anesthesia was given by one consultant anesthetist (at least 3 years 0f post-fellowship experience). All patients were followed by the researcher in the first 24 hours for presence or absence of dysphagia and sore throat. Results: The mean age was 34.78±6.30 years in group A and 34.38±6.37 years in group B. Majority of the patients 119 (77.27%) were between 25 to 40 years of age. There were 54 (35.06%) males and 100 (64.94%) were females with male to female ratio of ratio of 1:2.9. The complications of i-gel vs laryngeal mask airway supreme™ were found to be as follows; dysphagia on 0.0% vs 6.49% (p-value = 0.023) and sore throat in 3.90% vs 20.78% (p=0.001). Conclusion: The frequency of dysphagia and sore throat is less after i-gel use in laparoscopic cholecystectomy as compared to laryngeal mask airway supreme™. Keywords: General anesthesia, I-gel, Dysphagia

Airway Complications in Intubated Versus Laryngeal Mask Airway–Managed Dentistry: A Meta-Analysis

Objective: Serious airway complications can occur with inadequate airway management during general anesthesia (GA). This meta-analysis investigated randomized controlled trials that compared perioperative technique failures and airway complications, including hypoxia, during GA for dentistry using endotracheal intubation or a laryngeal mask airway (LMA) for airway management. Methods: A systematic search of electronic databases and gray literature was completed. Independent reviewers assessed eligibility, performed data extraction, completed risk of bias assessment, and judged the quality of results through Grading of Recommendations, Assessment, Development, and Evaluation. Risk ratios (RRs) for airway complications, with 95% CIs, were calculated. Heterogeneity was quantified using the I2 statistic. Sensitivity and age-subgroup analyses were explored. Results: Six trials were deemed eligible from a total of 9076 identified reports. The airway management intervention for these trials was LMA. Technique failures or effect differences in airway complications were not detected except for postoperative hypoxia, where LMA use had a decreased risk (RR, 0.22; 95% CI, 0.06-0.77; I2 = 0%; moderate quality). A similar effect was seen in the pediatric analysis (RR, 0.10; 95% CI, 0.01-0.84; I2 = 0%; moderate quality). Additionally, LMA use reduced pediatric sore throat risk (RR, 0.08; 95% CI, 0.04-0.15; I2 = 0%; moderate quality). Conclusion: Use of an LMA in dentistry may have the potential to reduce the risk of postoperative hypoxia, particularly in pediatric patients, although further study is required.