A comparison of supraglottic devices in pediatric patients

Krishna, Senthil G.; Syed, Faizaan; Hakim, Mohammed; Tumin, Dmitry; Veneziano, Giorgio; Tobias, Joseph D.

doi:10.2147/mder.s177866

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…The insertion time was then recorded as 120 s. The ease of insertion was graded from 1 to 4, indicating success at the first attempt with no resistance; success at the first attempt with mild resistance; success at the second attempt; and failure at the second attempt, respectively. 14 The FOB view grade, indicating whether the SLMA had been accurately positioned, 15 , 16 was categorised from 1 to 4, indicating glottis seen completely without any obstruction; glottis seen only partially, with visual obstruction less than 50%; glottis barely seen, with visual obstruction more than 50%; and glottis not seen, respectively. OLP was defined as the cuff pressure at which the gas leaked into the mouth, when the patient's head was kept in the neutral position, the expiratory valve was set at 70 cmH 2 O and gas flow was set at 3 l min −1 .…”

Section: Methodsmentioning

confidence: 99%

Incidence of postoperative sore throat after using a new technique of insertion of a second generation Laryngeal Mask Airway

Li¹,

Wang²,

Zhao³

et al. 2020

European Journal of Anaesthesiology

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BACKGROUND Sore throat is a common complication after Laryngeal Mask Airway Supreme (SLMA) insertion. OBJECTIVE The aim of this study was to determine whether a new SLMA insertion technique (not removing the pilot tube blocker before insertion) lowers the incidence of sore throat in the postanaesthesia care unit (PACU). DESIGN A prospective, single-centre, parallel randomised controlled trial. SETTING Operating room and PACU at a hospital in China from June to September 2019. PATIENTS Four hundred and eight patients aged 18 to 65 years with American Society of Anaesthesiologists physical status class I or II who were scheduled for elective surgery requiring anaesthesia and SLMA insertion. INTERVENTIONS Leaving the blocker at the end of the pilot tube in situ (this blocker keeps the valve open and the balloon remains partially inflated but will deflate with pressure) or removing the blocker and actively deflating the cuff before SLMA insertion. MAIN OUTCOME MEASURES The primary outcome was the incidence of postoperative sore throat in the PACU. The secondary outcomes included sore throat severity (Prince Henry Hospital Pain Score), first-attempt success rate, ease of insertion, time to successful SLMA insertion, oropharyngeal leak pressure, grade of view on fibreoptic bronchoscopy (indicating the accuracy of SLMA positioning) and adverse events. RESULTS The incidence of sore throat was 33/204 (16.2%) in the nonremoval group, and 65/204 (31.9%) in the removal group ( P < 0.001). The first-attempt success rate was 174/204 (85.3%) in the nonremoval group and 150/204 (73.76%) in the removal group ( P = 0.003; relative risk 1.160, 95% CI 1.049 to 1.282). The Kaplan--Meier curves showed that the insertion time in the nonremoval group was shorter (log-rank P = 0.01). CONCLUSION The new insertion technique, leaving the blocker attached to the end of the pilot balloon, resulted in a reduced incidence and severity of postoperative sore throat in the PACU, and an improved first-attempt success rate and the accuracy of SLMA positioning. TRIAL REGISTRATION Chinese Clinical Trial Registry identifier: ChiCTR1900023022

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Section: Methodsmentioning

confidence: 99%

Incidence of postoperative sore throat after using a new technique of insertion of a second generation Laryngeal Mask Airway

Li¹,

Wang²,

Zhao³

et al. 2020

European Journal of Anaesthesiology

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“…A series of randomized studies compared the air-Q R intubating laryngeal airway with the LMA R Unique TM (46), Ambu R Aurai TM (47,48), and i-gel R (49) in healthy children scheduled for elective surgery. Comparisons between the i-gel R and other SADs have also been reported (50)(51)(52)(53)(54)(55)(56)(57). In one study, although there was no statistically significant difference in the ease of device insertion, time to ventilation, gastric insufflation, or ventilation parameters between the air-Q R and the LMA R Unique TM , the air-Q R had higher airway leak pressures and superior fiberoptic grades of view (58).…”

Section: Head-to-head Comparisonsmentioning

confidence: 91%

Difficult Airway Management in Neonates and Infants: Knowledge of Devices and a Device-Oriented Strategy

et al. 2021

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Difficult airway management (DAM) in neonates and infants requires anesthesiologists and critical care clinicians to respond rapidly with appropriate evaluation of specific situations. Therefore, organizing information regarding DAM devices and device-oriented guidance for neonate and infant DAM treatment will help practitioners select the safest and most effective strategy. Based on DAM device information and reported literature, there are three modern options for DAM in neonates and infants that can be selected according to the anatomical difficulty and device-oriented strategy: (1) video laryngoscope (VLS), (2) supraglottic airway device (SAD), and (3) flexible fiberoptic scope (FOS). Some VLSs are equipped with small blades for infants. Advanced SADs have small sizes for infants, and some effectively function as conduits for endotracheal intubation. The smallest FOS has an outer diameter of 2.2 mm and enables intubation with endotracheal tubes with an inner diameter of 3.0 mm. DAM in neonates and infants can be improved by effectively selecting the appropriate device combination and ensuring that available providers have the necessary skills.

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“…In addition, the type of surgery, tube rotation angle for entering the glottis, duration of DLT, duration of laryngeal mask, and FOB view grade were also recorded. The FOB view grade, 15 indicating whether the laryngeal mask had been accurately positioned, was graded from 1 to 4: 1, indicating that the glottis was seen completely without any obstruction; 2, the glottis was seen only partially, with the visual obstruction less than 50%; 3, the glottis was barely seen, with the visual obstruction more than 50% and 4, the glottis was not seen.…”

Section: Methodsmentioning

confidence: 99%

The effects of video double-lumen tubes on intubation complications in patients undergoing thoracic surgery

Shui,

Hu,

et al. 2024

European Journal of Anaesthesiology

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BACKGROUND Tracheal injuries, vocal cord injuries, sore throat and hoarseness are common complications of double-lumen tube (DLT) intubation. OBJECTIVE This study aimed to evaluate the effects of ’video double-lumen tubes’ (VDLTs) on intubation complications in patients undergoing thoracic surgery. DESIGN A randomised controlled study. SETTINGT Xuzhou Cancer Hospital, Xuzhou, China, from January 2023 to June 2023. PATIENTS One hundred eighty-two patients undergoing elective thoracic surgery with one-lung ventilation were randomised into two groups: 90 in the DLT group and 92 in the VDLT group. INTERVENTION VDLT was selected for intubation in the VDLT group, and DLT was selected for intubation in the DLT group. A fibreoptic bronchoscope (FOB) was used to record tracheal and vocal cord injuries. MAIN OUTCOME MEASURES The primary outcomes were the incidence of moderate-to-severe tracheal injury and the incidence of vocal cord injury. The secondary outcomes included the incidence and severity of postoperative 24 and 48 h sore throat and hoarseness, RESULTS The incidence of moderate-to-severe tracheal injury was 32/90 (35.6%) in the DLT group, and 45/92 (48.9%) in the VDLT group (P = 0.077; relative risk 1.38, 95% CI, 0.97 to 1.95). The incidence of vocal cord injury was 31/90 (34.4%) and 34/92 (37%) in the DLT and VDLT groups, respectively (P = 0.449). The incidence of postoperative 24 h sore throat and hoarseness was significantly higher in the VDLT group than in the DLT group (for sore throat: P = 0.032, relative risk 1.63, 95% CI, 1.03 to 2.57; for hoarseness: P = 0.018, relative risk 1.48, 95% CI, 1.06 to 2.06). CONCLUSION There was no statistically significant difference in the incidence of moderate-to-severe tracheal injury and vocal cord injury between DLTs and VDLTs. While improving the first-attempt success rate, intubation with VDLT increased the incidence of postoperative 24 h sore throat and hoarseness. TRIAL REGISTRATION Chinese Clinical Trial Registry identifier: ChiCTR2300067348.

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A comparison of supraglottic devices in pediatric patients

Cited by 6 publications

References 18 publications

Incidence of postoperative sore throat after using a new technique of insertion of a second generation Laryngeal Mask Airway

Incidence of postoperative sore throat after using a new technique of insertion of a second generation Laryngeal Mask Airway

Difficult Airway Management in Neonates and Infants: Knowledge of Devices and a Device-Oriented Strategy

The effects of video double-lumen tubes on intubation complications in patients undergoing thoracic surgery

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