A comparative study of three methods of ProSeal laryngeal mask airway insertion in children with simulated difficult laryngoscopy using a rigid neck collar

Das, Bikramjit; Mitra, Subhro; Samanta, Arijit; Samal, Rajiv Kumar

doi:10.1016/j.aat.2014.05.009

Cited by 6 publications

(6 citation statements)

References 19 publications

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“…In our study, the application of a neck collar reduced both head and neck movement and mouth opening. Reduced mouth opening has been reported in patients with neck collars [ 11 ]. Reduced neck movement leads to reduced head flexion, which contributes to the worsening of Cormack-Lehane grades with direct laryngoscopy [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

A comparison of angled (D-Blade) and Macintosh (C-MAC) videolaryngoscopes for simulated difficult airway in pediatric patients: a randomized single-blind study.

2021

Turk J Med Sci

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Background/aim Being prepared for difficult airway (DA) is nevertheless of great importance. Failed or delayed tracheal intubation (TI) can increase morbidity and mortality, and the pediatric population is more prone to hypoxia. With the development of different types of videolaryngoscope (VL), these have become the device of choice in patients with DA. Our primary aim was to compare intubation times with D-blade and Macintosh blade of Storz C-MAC ® in a simulated pediatric DA scenario with this randomized controlled trial. Materials and methods Children aged 1–5 years scheduled for elective surgery were included in the study. Patients were randomized into two groups: the D-Blade (n = 20) and MAC (n = 21) groups. All children underwent inhalational induction, and a neuromuscular relaxant was routinely administered (rocuronium 0.6 mg.kg-1). After the appropriate size of semirigid foam neck collar had been positioned around the patient’s neck, the D-Blade group patients were intubated using a size 2 D-Blade, and the MAC group patients used a size 2 VL Macintosh blade. Intubation, time was measured. Patients’ modified Cormack-Lehane system scores (MCLS), pre and postintubation blood pressure values and heart rates, and complications during intubation were recorded. Results Demographic data were similar between the groups. There were also no significant differences in pre and postintubation heart rates, blood pressure, or SpO2 values (p > 0.05 for all). Mean intubation times for the MAC and D-Blade groups were 12.14 ± 2.79 s and 18.31 ± 10.86 s, respectively (p = 0.022). MCLS scores were lower in the D-Blade group (p = 0.030). Intubation success rates were 100% in the MAC group and 90% in the D-Blade group, although the difference was statistically insignificant (p = 0.165). Conclusion A better laryngoscopic view was obtained with D-Blade. However, the Storz® C-Mac videolaryngoscope Macintosh blade was superior to the D-Blade in achieving a shorter time for TI.

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Section: Discussionmentioning

confidence: 99%

A comparison of angled (D-Blade) and Macintosh (C-MAC) videolaryngoscopes for simulated difficult airway in pediatric patients: a randomized single-blind study.

2021

Turk J Med Sci

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“…It has been shown that the insertion techniques can significantly change the ease and success rate of PLMA insertion, time required for effective airway, airway leakage pressure, success rate of nasogastric tube insertion, and incidence of complications. 2 , 3 We believe that addressing this issue would further clarify the transparency of this study.…”

mentioning

confidence: 86%

“…Secondly, in our study, PLMA were inserted digitally. Das et al 3 previously compared 3 PLMA insertion methods in child patients with rigid cervical collars. They performed comparisons between the method combining the stylet and inserter apparatus, a method using the inserter apparatus and the conventional digital insertion method.…”

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confidence: 99%

Comparing performance of ProSeal laryngeal mask airway and I-gel in anesthetized adult patients

Zhang

Meng

Xue

et al. 2015

SMJ

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“…Several techniques continue to be developed to improve the placement and performance characteristics of PLMA in pediatric patients; the introducer, pharyngoscopy, 90° and 180° rotation technique, partially inflated cuff, suction catheter, and gum elastic bougie technique. [ 2 3 4 5 6 7 ] The correct placement may be more difficult in children due to the relatively larger tongue, a superior larynx with a floppy epiglottis, and the frequent presence of hypertrophied tonsils. [ 7 ] The success rate of inserting LMAs in pediatric patients at the first attempt varies between 67%–92%.…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of insertion characteristics of PLMA using different techniques in the pediatric age group

Tiwari,

Seth

2024

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aims: The laryngeal mask airway ProSeal (PLMA) insertion should be easy, fast, and atraumatic. Most studies have been done on adults who cannot be considered as the reflection of pediatric patients. In this study, we compared the first attempt success rate of three techniques of PLMA insertion: introducer, 90° rotation, and pharyngoscopy technique in the pediatric population. Material and Methods: In this prospective comparative randomized study, a total of 135 patients of American Society of Anesthesiology grade I and II, aged three to eleven years, with normal airways scheduled for elective surgery, were randomly allocated into three groups: introducer, 90° rotation, and pharyngoscopy group. Parameters evaluated were: first attempt insertion success rate, insertion time, ease of insertion score, hemodynamic parameters, oropharyngeal seal pressure, manipulations, PLMA blood staining, postoperative sore throat, and hoarseness. Results: First attempt insertion success rate was higher in the 90° rotation (97.78%) and pharyngoscopy (97.78%) group as compared to the introducer group (93.33%). But the result was not statistically significant. PLMA insertion time was the least in the rotation group, followed by the pharyngoscopy and introducer group (P < 0.0001). Mean arterial pressure and heart rate were significantly raised in the pharyngoscopy versus rotation group and the introducer versus 90° rotation group after PLMA insertion. Oropharyngeal seal pressure was significantly higher in the introducer as compared to the rotation group (P = 0.007). Conclusion: All three techniques had a high first-attempt insertion success rate. As the rotation technique had the best result in insertion time and hemodynamic response, it may be considered a good alternative to pharyngoscopy and introducer technique in pediatric patients of age three to eleven years with a normal airway. Key Messages: Several studies on PLMA insertion technique in adults are present, but few in the pediatric population. Introducer, pharyngoscopy, and 90° rotation technique were compared. The rotation technique was better in terms of insertion time and hemodynamic stability.

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A comparative study of three methods of ProSeal laryngeal mask airway insertion in children with simulated difficult laryngoscopy using a rigid neck collar

Abstract: PLMA insertion with combined IT and stylet technique was more frequently successful than the digital or IT technique in pediatric patients without cervical spine motion.

Cited by 6 publications

References 19 publications

A comparison of angled (D-Blade) and Macintosh (C-MAC) videolaryngoscopes for simulated difficult airway in pediatric patients: a randomized single-blind study.

A comparison of angled (D-Blade) and Macintosh (C-MAC) videolaryngoscopes for simulated difficult airway in pediatric patients: a randomized single-blind study.

Comparing performance of ProSeal laryngeal mask airway and I-gel in anesthetized adult patients

Comparative evaluation of insertion characteristics of PLMA using different techniques in the pediatric age group

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