A Survey of Provider Satisfaction of a New, Flexible Extended-Length Pharyngeal Airway to Relieve Upper Airway Obstruction During Deep Sedation

Abstract

BackgroundMaintaining an open airway in a spontaneously-breathing patient under deep sedation, or deep monitored anaesthesia care, can be challenging. Specifically, current oral airways are not long enough to displace obstruction caused by redundant pharyngeal tissue, prompting external maneuvers by anesthetists that can impact patient outcomes and facility operational efficiency. As procedures increase at outpatient surgical centers, there is a need for an anesthesia provider-validated airway device that can sufficiently open an obstructed airway and maintain airway patency.MethodsThis prospective, multi-center user-experience survey evaluated anesthesia provider experience of a new airway device for adult patients with airway obstruction during deep sedation. The novel external airway has a longer flexible tubing allowing for displacement of pharyngeal tissue, smaller diameter to allow placement alongside an endoscopy bite block, and is manufactured with softer material to allow ease of insertion and patient comfort.ResultsFifty-four anaesthetists at 15 hospital systems reported their experience of airway use in 86 cases. The novel airway device was 95% successful in establishing and maintaining a patent airway (n=68). Survey responses indicated that the airway was easy to place (93%), allowed for a “hands-off approach” (98%), and would improve airway management practice and patient outcomes (86%).ConclusionsThis pilot study demonstrated that the novel external airway is an effective and satisfactory method for anaesthesia providers to alleviate airway obstruction during deep sedation. Additional studies will be initiated to confirm efficacy and cost-effectiveness in patient populations and clinical environments that will most benefit from the new airway device.

Introducing the First Distal Pharyngeal Airway

“…In a survey of 35 anesthesia providers who used 42 DPAs during deep sedation, the DPA was reported to decrease upper airway obstruction and allow for adequate ventilation in 100% of cases. 14 When compared to oropharyngeal or nasopharyngeal airways, the DPA more readily maintained a patent airway in 88% of cases. 14 The DPA's small diameter allows it to be placed alongside other devices, notably the endoscopy bite block (Figure 3).…”

“…14 When compared to oropharyngeal or nasopharyngeal airways, the DPA more readily maintained a patent airway in 88% of cases. 14 The DPA's small diameter allows it to be placed alongside other devices, notably the endoscopy bite block (Figure 3). The "2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway" recommend "supplemental oxygen administration before initiating and throughout difficult airway management, including the extubation process."…”

“… 14 When compared to oropharyngeal or nasopharyngeal airways, the DPA more readily maintained a patent airway in 88% of cases. 14 …”

“…Of 35 surveyed providers, 93% asserted that the device was easy to place, and the remaining 7% felt it was moderately easy to place. 14 Upper airway obstruction during deep sedation and anesthesia is a common problem and typically necessitates the use of an airway device. As described above, the DPA is designed specifically to eliminate issues associated with traditional airway devices.…”

“…In a survey of 35 anesthesia providers who used 42 DPAs during deep sedation, 97% of DPA placements allowed for a “hands-off approach” and eliminated the need for chin lift or jaw thrust maneuvers. 14 The DPA is easy to insert and requires no setup or additional equipment. Of 35 surveyed providers, 93% asserted that the device was easy to place, and the remaining 7% felt it was moderately easy to place.…”