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Comparison of i-gel™ supraglottic device with classic laryngeal mask airway in anesthetized paralyzed children undergoing elective surgery.

ABSTRACT: The newest variation of the i-gel supraglottic airway is a pediatric version.This study was designed to investigate the usefulness of the size 2 i-gel compared with the classic laryngeal mask airway (cLMA) of the same size in anesthetized, paralyzed children.A prospective, randomized, single-blinded study was conducted in tertiary care teaching hospital.Sixty ASA grade I-II patients undergoing lower abdominal, inguinal, and orthopedic surgery were included in this prospective study. The patients were randomly assigned to i-gel and cLMA groups (30 patients in each group). Size 2 supraglottic airway was inserted according to the assigned group. We assessed ease of insertion, hemodynamic data, oropharyngeal sealing pressure, and postoperative complications.Parametric data were analyzed with the unpaired t-test and non-parametric data were analyzed with the Chi-square test. Unless otherwise stated, data are presented as mean (SD). Significance was taken as P < 0.05.There were no differences in the demographic and hemodynamic data among the two groups. The airway leak pressure of the i-gel group (26.1 ± 2.4 cm H2O) was significantly higher than that of the cLMA group (22.64 ± 2.2 cm H2O). The success rates for first attempt of insertion were similar among the two devices. There were no differences in the incidence of postoperative airway morbidity among the two groups.Hemodynamic parameters, ease of insertion, and postoperative complications were comparable between the i-gel and cLMA groups, but airway sealing pressure was significantly higher in i-gel group.

SUBMITTER: Das B

PROVIDER: S-EPMC4173459 | biostudies-other | 2012 Jul-Dec

REPOSITORIES: biostudies-other

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Comparison of i-gel™ supraglottic device with classic laryngeal mask airway in anesthetized paralyzed children undergoing elective surgery.

Das Bikramjit B Mitra Subhro S Samanta Arijit A Vijay Bhavani S BS

Anesthesia, essays and researches 20120701 2

<h4>Context</h4>The newest variation of the i-gel supraglottic airway is a pediatric version.<h4>Aims</h4>This study was designed to investigate the usefulness of the size 2 i-gel compared with the classic laryngeal mask airway (cLMA) of the same size in anesthetized, paralyzed children.<h4>Settings and design</h4>A prospective, randomized, single-blinded study was conducted in tertiary care teaching hospital.<h4>Subject and methods</h4>Sixty ASA grade I-II patients undergoing lower abdominal, i ...[more]

PMID: 25885613

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Project description:BACKGROUND:Laryngeal mask UNIQUE® (LMAU) is supraglottic airway device with good clinical performance and low failure rate. Little is known about the ideal position of the LMAU on the magnetic resonance imaging (MRI) and whether radiological malposition can be associated with clinical performance (audible leak) in children. The primary aim of the study was to evaluate incidence of the radiologic malposition of the LMAU according to size. The secondary outcome was the clinical performance and associated complications (1st attempt success rate, audible leak) in LMAUs in correct position vs. radiologically misplaced LMAUs. METHODS:In prospective observational study, all paediatric patients undergoing MRI of the brain under general anaesthesia with the LMAU were included (1.9.2016-16.5.2017). The radiologically correct position: LMAU in hypopharynx, proximal cuff opposite to the C1 or C2 and distance A (proximal cuff end and aditus laryngis)???distance B (distal cuff end and aditus laryngis). Malposition A: LMAU outside the hypopharynx. Malposition B: proximal cuff outside C1-C2. Malposition C: distance A???distance B. We measured distances on the MRI image. Malposition incidence between LMAU sizes and first attempt success rate in trainees and consultant groups was compared using Fisher exact test, difference in incidence of malpositions using McNemar test and difference in leakage according to radiological position using two-sample binomial test. RESULTS:Overall 202 paediatric patients were included. The incidence of radiologically defined malposition was 26.2% (n?=?53). Laryngeal mask was successfully inserted on the 1st attempt in 91.1% (n?=?184) cases. Audible leak was detected in 3.5% (n?=?7) patients. The radiologically defined malposition was present in 42.9% (n?=?3) cases with audible leak. The rate of associated complications was 1.5% (n?=?3): laryngospasm, desaturation, cough. In 4.0% (n?=?8) the LMAU was soiled from blood. Higher incidence of radiological malposition was in LMAU 1.0, 1.5 and LMAU 3, 4 compared to LMAU 2 or LMAU 2.5 (p?<?0.001). CONCLUSION:Malposition was not associated with impaired clinical performance (audible leak, complications) of the LMAU or the need for alternative airway management. TRIAL REGISTRATION:Clinicaltrials.gov (NCT02940652) Registered 18 October 18 2016.

Project description:BACKGROUND:The intubating laryngeal mask Fastrach™ is considered a gold standard for blind intubation as well as for fibreoptic guided intubation via a laryngeal mask. Recently, a single use version of the mask has been introduced. We compared the Fastrach single use with the new, low-priced single use intubating laryngeal mask Ambu Aura-i™. We hypothesised that the LMA Ambu Aura-i and the LMA Fastrach are comparable with respect to success rates for mask placement and blind tracheal intubation through the LMA device. METHODS:A prospective, randomised clinical trial. University Hospital Schleswig-Holstein, Campus Kiel, from April 2011 to April 2012. Eighty patients undergoing general anaesthesia with planned tracheal intubation were randomised and enrolled in the study. Blind intubation was performed with either laryngeal mask using two different tracheal tubes (Rüsch Super Safety Silk™ and LMA ETT™). A crossover-design was performed after an unsuccessful procedure. Primary outcome measure was the overall success rate of blind intubation. Secondary outcome measures were the time to the first adequate ventilation, a subjective handling score, and a fibreoptic control of placement, as well as the success rate of mask placement, time for mask removal after successful intubation, differences in airway leak pressure, and the incidence of postoperative sore throat and hoarseness. RESULTS:The success rate of tracheal intubation with the Fastrach for the first and second attempt was significantly better compared with the Ambu Aura-i. Tracheal intubation was also significantly faster (14.1 s. ±4.4 versus 21.3 s. ±9.0; p < 0.01), and the time interval for mask removal after successful intubation was significantly shorter using the Fastrach device (24.0 s. ±8.2 versus 29.4 s. ±7.5; p < 0.001). There were no significant differences between groups regarding the incidence of postoperative sore throat and hoarseness. CONCLUSION:Both laryngeal mask devices are suitable for ventilation and oxygenation. Blind intubation remains the domain of the LMA Fastrach, the Ambu Aura-i is not suitable for blind intubation. TRIAL REGISTRATION:Clinicaltrials.gov Identification Number NCT03109678 , retrospectively registered on April 12, 2017.

Dataset Information

Comparison of i-gel™ supraglottic device with classic laryngeal mask airway in anesthetized paralyzed children undergoing elective surgery.

Publications

Comparison of i-gel™ supraglottic device with classic laryngeal mask airway in anesthetized paralyzed children undergoing elective surgery.

Similar Datasets

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