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Performance of size 1 I-gel compared with size 1 ProSeal laryngeal mask in anesthetized infants and neonates.

ABSTRACT: The size 1 I-gel, recommended for small infants and neonates weighing 2-5 kg, has recently been released. There are no prospective studies available that assess the insertion conditions, sealing pressures, or ventilation quality of it. This study was designed to compare the performance of recently released size 1 I-gel with size 1 ProSeal LMA.Fifty infants and neonates, ASA I-II were included in this prospective, randomized, and controlled study. Patients were divided into two groups for placing I-gel or ProSeal LMA. The primary outcome was airway leak pressure, and secondary outcomes included insertion time, insertion success and conditions, initial airway quality, fiberoptic view of the larynx, and complications.There were no significant differences in terms of airway leak pressure between the I-gel (27.44 ± 5.67) and ProSeal LMA (23.52 ± 8.15) (P = 0.054). The insertion time for the I-gel was shorter (12.6 ± 2.19 s) than for the ProSeal LMA (24.2 ± 6.059 s) (P = 0.0001). Insertion success and conditions were similar in groups. We encountered few complications.Our study demonstrates that the size 1 I-gel provided an effective and satisfactory airway as the size 1 ProSeal LMA. It may be a good alternative supraglottic airway device for use in small infants and neonates. This trial is registered with: ClinicalTrials.gov NCT01704118.

SUBMITTER: Kayhan GE

PROVIDER: S-EPMC4352429 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Performance of size 1 I-gel compared with size 1 ProSeal laryngeal mask in anesthetized infants and neonates.

Kayhan Gulay Erdogan GE Begec Zekine Z Sanli Mukadder M Gedik Ender E Durmus Mahmut M

TheScientificWorldJournal 20150222

<h4>Purpose</h4>The size 1 I-gel, recommended for small infants and neonates weighing 2-5 kg, has recently been released. There are no prospective studies available that assess the insertion conditions, sealing pressures, or ventilation quality of it. This study was designed to compare the performance of recently released size 1 I-gel with size 1 ProSeal LMA.<h4>Methods</h4>Fifty infants and neonates, ASA I-II were included in this prospective, randomized, and controlled study. Patients were div ...[more]

PMID: 25793219

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Project description:The Guardian Laryngeal Mask Airway (G-LMA) is a new silicone-based single-use extraglottic device with the drainage port and a cuff pilot valve with pressure indicator. The aim of this study is to compare the clinical performance of this laryngeal mask airway with ProSeal laryngeal mask airway (P-LMA).In this prospective randomized study, we included adult patients with ASA grading I and II scheduled for elective surgery requiring supine position under total intravenous anesthesia. The patients were randomly allocated to two groups, 40 in each. G-LMA and P-LMA were used in groups G and P respectively. The cuff of each device was air inflated to 60 cmH2O. The primary outcome was to compare the airway sealing pressure and the secondary outcome was to compare the efficacy and safety of these two devices with respect to insertion success, insertion time, ease of insertion, volume of air for cuff inflation to 60 cmH2O, intracuff pressure measurement, gastric tube insertion attempt, gastric tube insertion time, Fiberoptic laryngeal view, and postoperative pharyngolaryngeal morbidity.The airway sealing pressure at 60 cmH2O cuff pressure was significantly greater in G-LMA than P-LMA (p?=?0.04).The first successful attempt of both groups were comparable (p?=?1.000). Insertion time was significantly shorter in G-LMA than P-LMA (p?<?0.0001). The first successful attempt for the gastric tube insertion in both groups was comparable (p?=?0.431). Gastric tube insertion time was less in G-LMA than in P-LMA (p?<?0.0001). The volume of air for cuff inflation to 60 cmH2O was more in G-LMA than in P-LMA (<0.0001). The intracuff pressure measurement at 30, 60, 90 and 120 minutes were comparable (p?=?0.823, 0.182, 0.870, 0.658).We did not find differences in ease of insertion (p?=?0.60); Fiber-optic positions of airway devices were comparable (p?=?0.83). In addition, blood staining (p?=?1.00), sore throat and dysphagia at 1, 2 and 24 hour (p?=?1.00) were comparable in both groups.The Guardian laryngeal mask airway was associated with high airway sealing pressure with a quicker insertion of the device as well as gastric tube.Clinical Trial.gov Identifier: NCT02063516. Date: June 2013.

Project description:BackgroundProSeal (PLMA) and Supreme (SLMA) laryngeal mask airways are effective ventilator devices with distinctive designs that may require different anaesthetics for insertion. Sevoflurane induction provides acceptable conditions for laryngeal mask insertion, and remifentanil significantly decreases the minimum alveolar concentration of sevoflurane required for that insertion. The study aimed to evaluate the optimal end-tidal (ET) sevoflurane concentration for successful insertion of PLMA versus SLMA in patients receiving a remifentanil infusion without a neuromuscular blocking agent.MethodsAltogether, 45 patients ASA (American Society Anaesthesiologists) physical status I-II, aged 18-60 years were scheduled for elective ambulatory surgery. Exclusion criteria were a difficult airway, recent respiratory infection, reactive airway, obstructive sleep apnoea syndrome, gastric aspiration's risk factors, pregnancy, and lactation. Patients were randomly allocated to receive the SLMA or the PLMA. Sevoflurane induction with co-administration of remifentanil was performed at an effect-site concentration of 4 ng mL- 1. ET50 was calculated with a modified Dixon's up-and-down method (starting at 2.5% in steps of 0.5%). Predetermined sevoflurane concentration was kept constant during the 10 min before LMA insertion. Patient's response to LMA insertion was classified as "movement" or "no movement". Sevoflurane ET50 was determined as the midpoint concentration of all the independent pairs that manifested crossover from "movement" to "no movement".ResultsThe ET50 sevoflurane concentration co-administered with remifentanil required for PLMA insertion was 1.20 ± 0.41% (95% confidence interval 0.76 to 1.63%). For SLMA insertion, it was 0.55 ± 0.38% (95% confidence interval 0.14 to 0.95%) (p = 0.019).ConclusionsThe end-tidal sevoflurane concentration with co-administered remifentanil required to allow insertion of the SLMA was 54% lower than that needed for inserting the PLMA.Trial registrationClinicaltrials.gov identifier: NCT03003377. Retrospectively registered. Date of registration: December 28, 2016.

Dataset Information

Performance of size 1 I-gel compared with size 1 ProSeal laryngeal mask in anesthetized infants and neonates.

Publications

Performance of size 1 I-gel compared with size 1 ProSeal laryngeal mask in anesthetized infants and neonates.

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