A prospective randomized trial comparing supraglottic airways for flexible bronchoscopy in children

Baker, Paul; Brunette, Katharine E.J.; Byrnes, Catherine A; Thompson, Graham C.

doi:10.1111/j.1460-9592.2010.03362.x

Cited by 16 publications

(9 citation statements)

References 21 publications

(22 reference statements)

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“…We included published prospective human clinical trials where the AuraOnce was compared with the LMA Classic, LMA Unique and Soft Seal. A total of nine articles included one of these comparisons; however, one article was excluded as the study was conducted in children . A flow diagram of study selection is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

Comparative efficacy and safety of the Ambu^® AuraOnce^™ laryngeal mask airway during general anaesthesia in adults: a systematic review and meta‐analysis

et al. 2014

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SummaryPrevious comparisons between the Ambu â AuraOnce TM and other laryngeal mask airways have revealed different results across various clinical studies. We aimed to perform a systematic review with meta-analysis on the efficacy and safety of the AuraOnce compared with other laryngeal mask airways for airway maintenance in adults undergoing general anaesthesia. Our search of PubMed, PubMed Central, Scopus and the Central Register of Clinical Trials of the Cochrane Collaboration yielded nine randomised controlled trials eligible for inclusion. Comparator laryngeal mask airways were the LMA Unique TM (four trials), the LMA Classic â (five trials) and the Portex â Soft Seal â (three trials). The AuraOnce provided an oropharyngeal leak pressure higher than the LMA Unique (304 participants, mean (95% CI) difference 3.1 (1.6-4.7) cmH 2 O, p < 0.0001) and equivalent to the LMA Classic. The Soft Seal provided a higher leak pressure than the AuraOnce (229 participants, mean (95% CI) difference 3.5 (0.4-6.7) cmH 2 O, p = 0.03). Insertion was significantly faster with the AuraOnce than the LMA Unique (304 participants, mean (95% CI) difference 5.4 (2.1-8.71) s, p = 0.001) and Soft Seal (229 participants, mean (95% CI) difference 9.5 (3.0-15.9) s, p = 0.004), but similar to the LMA Classic. The first-insertion success rate of the AuraOnce was equivalent to the LMA Unique, LMA Classic and Soft Seal. We found a higher likelihood of bloodstaining on the cuff with the Soft Seal and a higher incidence of sore throat with the LMA Classic. We conclude that the AuraOnce is an effective alternative to the LMA Classic and LMA Unique, and easier to insert than all three other devices studied.

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Section: Resultsmentioning

confidence: 99%

Comparative efficacy and safety of the Ambu^® AuraOnce^™ laryngeal mask airway during general anaesthesia in adults: a systematic review and meta‐analysis

et al. 2014

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“…When a fibrescope is used to visualize and intubate the larynx via a SAD, an important factor in success is the ease of manipulation of the fibreoptic device. The silicone classic laryngeal mask airway offers less resistance to bronchoscopic manipulation when compared to single‐use polyvinyl chloride (PVC) SADs . Such seemingly, small individual components of the difficult intubation package mark the difference between success and failure at the extremes of difficulty when dealing with challenging pediatric airways.…”

Section: Supraglottic Airway Devicesmentioning

confidence: 99%

Are new supraglottic airway devices, tracheal tubes and airway viewing devices cost‐effective?

Slinn

Froom

Stacey

et al. 2014

Pediatric Anesthesia

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Over the past two decades, a plethora of new airway devices has become available to the pediatric anesthetist. While all have the laudable intention of improving patient care and some have proven clinical benefits, these devices are often costly and at times claims of an advantage over current equipment and techniques are marginal. Supraglottic airway devices are used in the majority of pediatric anesthetics delivered in the U.K., and airway-viewing devices provide an alternative for routine intubation as well as an option in the management of the difficult airway. Yet hidden beneath the convenience of the former and the technology of the latter, the impact on basic airway skills with a facemask and the lack of opportunities to fine-tune the core skill of intubation represent an unrecognised and unquantifiable cost. A judgement on this value must be factored into the absolute purchase cost and any potential benefits to the quality of patient care, thus blurring any judgement on cost-effectiveness that we might have. An overall value on cost-effectiveness though not in strict monetary terms can then be ascribed. In this review, we evaluate the role of these devices in the care of the pediatric patient and attempt to balance the advantages they offer against the cost they incur, both financial and environmental, and in any quality improvement they might offer in clinical care.

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“…It is expensive, can be awkward to set up, and is difficult to clean, and so is less likely to be used routinely to maintain skills. In children, however, it has the advantage of facilitating intubation through the laryngeal mask airway, which is handy as a large proportion of challenging airways can be successfully managed with a laryngeal mask airway (although the bronchoscope may be gripped by the shaft of some brands of single‐use laryngeal mask airways (22)). The fiberoptic bronchoscope is also available in a size that is suitable even for a neonate.…”

Section: The Challenging Laryngoscopymentioning

confidence: 99%

The normal and the challenging pediatric airway

Sims

Ungern‐Sternberg

2012

Pediatric Anesthesia

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Management of a child's airway is one of the main sources of stress for anesthetists who do not routinely anesthetize children. Unfortunately, trainees are gaining less experience in pediatric airway management than in the past, which is particularly difficult at a time when some beliefs about airway management are being challenged and airway management is less standardized. Fortunately, most children have an easily managed, normal airway. Nevertheless, it is of vital importance to teach our trainees the basic airway skills that are probably the most important skill in an anesthetists' repertoire when it comes to a difficult airway situation. This review focuses on the airway management in children with a normal and a challenging airway. Different choices of airway management in children, and their advantages and disadvantages are discussed. Furthermore, the three broad causes of a challenging airway in children and infants are highlighted - the difficulty obtaining a mask seal, difficulty visualizing the vocal cords, and the third cause in which the larynx can be visualized but the difficulty lies at or beyond that level. Guidelines are given how to deal with these patients as well as with the feared but rare scenario of 'cannot ventilate, cannot intubate' in children.

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A prospective randomized trial comparing supraglottic airways for flexible bronchoscopy in children

Abstract: In this trial, PVC single-use laryngeal masks were inferior to the silicone cLMA and Boss Systems laryngeal masks for flexible bronchoscopy in children.

Cited by 16 publications

References 21 publications

Comparative efficacy and safety of the Ambu^® AuraOnce^™ laryngeal mask airway during general anaesthesia in adults: a systematic review and meta‐analysis

Comparative efficacy and safety of the Ambu^® AuraOnce^™ laryngeal mask airway during general anaesthesia in adults: a systematic review and meta‐analysis

Are new supraglottic airway devices, tracheal tubes and airway viewing devices cost‐effective?

The normal and the challenging pediatric airway

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A prospective randomized trial comparing supraglottic airways for flexible bronchoscopy in children

Abstract: In this trial, PVC single-use laryngeal masks were inferior to the silicone cLMA and Boss Systems laryngeal masks for flexible bronchoscopy in children.

Cited by 16 publications

References 21 publications

Comparative efficacy and safety of the Ambu® AuraOnce™ laryngeal mask airway during general anaesthesia in adults: a systematic review and meta‐analysis

Comparative efficacy and safety of the Ambu® AuraOnce™ laryngeal mask airway during general anaesthesia in adults: a systematic review and meta‐analysis

Are new supraglottic airway devices, tracheal tubes and airway viewing devices cost‐effective?

The normal and the challenging pediatric airway

Contact Info

Product

Resources

About

Comparative efficacy and safety of the Ambu^® AuraOnce^™ laryngeal mask airway during general anaesthesia in adults: a systematic review and meta‐analysis

Comparative efficacy and safety of the Ambu^® AuraOnce^™ laryngeal mask airway during general anaesthesia in adults: a systematic review and meta‐analysis