Airway management using LMA-evaluation of three insertional techniques-a prospective randomised study

Shyam, T.; Selvaraj, Venkatesh

doi:10.4103/joacp.joacp_60_19

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…They assessed the success rates of standard, 90° rotational and 180° rotational techniques and reported that 180° and 90° rotation techniques were associated with better results compared to the standard method. [ 25 ] In another study by Mahmoodpoor and colleagues, they assessed the standard and two rotational methods of LMA placement in 150 adult patients undergoing anesthesia. Based on the results of this study, inserting the LMA using lateral rotation was associated with higher success rates and lower insertion time.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of four techniques to administer laryngeal mask airway

2023

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Background: Laryngeal mask airway (LMA) plays a crucial role in the field of modern anesthesia. There are different techniques to administer LMA. Here we aimed to compare the four methods of standard, 90° rotation, 180° rotation, and thumb placement in LMA mast placement. Materials and Methods: This is a clinical trial that was performed on 257 candidates of elective surgical operations requiring general anesthesia. All patients were categorized into four groups of LMA placement with index finger (standard method), mask placement with 90° rotation, 180° rotation method, and thumb finger group. We collected data regarding the success rates of LMA placement, the need for any manipulation when placing the mask, LMA placement time, failure of mask placement, presence of blood on the LMA, and laryngospasm and sore throats 1 hour after surgery in patients. Results: The 90° rotation method had a significantly higher first attempt success rate than that in the other three methods (98.4%, P = 0.02). Total success rate in 90° rotation method was also significantly higher than the other techniques (100%, P < 0.001). The need for any manipulation when placing the mask (1.6%, P = 0.01), presence of blood on the LMA mask (1.6%, P = 0.33), and frequency of sore throats 1 hour after surgery (21.9%, P = 0.14) were also lower in 90° rotation method than that in the other methods. Conclusion: The 90° rotation method had significantly higher success rate and lower failure rate regarding the mask placement compared to other three methods.

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Section: Discussionmentioning

confidence: 99%

Evaluation of four techniques to administer laryngeal mask airway

2023

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“…Shyam and Selvaraj explored 3 distinct LMA insertion methods. The first method involved the standard technique, the second method, known as the 90° rotation technique, and the third method (referred to as the 180° rotation technique) ( 12 ). The researchers concluded that the 180° rotation technique of LMA insertion is more efficacious than the 90° rotation technique in adult patients under general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…The third method, referred to as the 180° rotation technique, involved the insertion of the LMA from the back to the front, similar to Godel’s airway. Based on their findings, the researchers concluded that the 180° rotation technique of LMA insertion is more effective than the 90° rotation technique in adult patients under general anesthesia ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Conditions for Insertion of the Laryngeal Mask Airway in an Innovative Method vs the Classic Method

Shetabi,

Shahriari,

Aghadavoudi

2023

Anesth Pain Med

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Background: A laryngeal mask airway (LMA) is a simple and non-invasive device used to establish the airway and maintain ventilation and oxygenation during short-duration medical procedures. Objectives: This study aimed to compare the placement of an LMA using an innovative technique vs the classic method. Methods: This clinical trial was conducted at Faiz Hospital in Isfahan. Out of 110 candidates for elective eye surgery, 10 patients were excluded from the study as they did not meet the inclusion criteria. Ultimately, 100 patients were randomly allocated to 2 groups of 50 each. One group underwent LMA insertion using the classic method, while the other group underwent insertion using the face-to-face triple maneuver technique (FFTMT). Data, including laryngeal mask insertion conditions, hemodynamic responses, and clinical complications, were collected, entered into SPSS version 26, and analyzed. Results: There were no significant differences between the 2 groups in terms of laryngeal mask placement time (P = 0.061), number of attempts to place the LMA (P = 0.059), oropharyngeal leak pressure (OLP; P = 0.942), frequency of hoarseness (P > 0.99), or laryngospasm (P > 0.99). However, it is noteworthy that FFTMT appeared to provide easier placement of the LMA (P < 0.0001), required fewer attempts, and offered better quality of ventilation with a lower presence of blood on the cuff (P = 0.038). Conversely, the FFTMT group had a higher frequency of sore throat (P < 0.0001). Conclusions: The performance of LMA using FFTMT is comparable to the classic method. In procedures under sedation where the surgeon has access to the patient’s head and neck (such as cataract surgery), airway management with LMA using FFTMT (while maintaining the patient’s sterile covering) appears to be effective in case of an emergency.

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“…The 90 • rotational technique is similar to the 180 • technique except that after the LM device with a fully deflated cuff is inserted laterally into the mouth, it is rotated counterclockwise through 90 • and advanced and straightened out in the hypopharynx. These rotational techniques have been shown to be better than the standard technique in randomized trials in children and adults during anesthesia [41][42][43]. Nevertheless, apart from the standard technique, none of these techniques have been studied in newborn infants during resuscitation.…”

Section: Insertion Technique and Trainingmentioning

confidence: 99%

Laryngeal Masks in Neonatal Resuscitation—A Narrative Review of Updates 2022

2022

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Positive pressure ventilation (PPV) is crucial to neonatal cardiopulmonary resuscitation because respiratory failure precedes cardiac failure in newborns affected by perinatal asphyxia. Prolonged ineffective PPV could lead to a need for advanced resuscitation such as intubation, chest compression, and epinephrine. Every 30 s delay in initiation of PPV increased the risk of death or morbidity by 16%. The most effective interface for providing PPV in the early phases of resuscitation is still unclear. Laryngeal masks (LMs) are supraglottic airway devices that provide less invasive and relatively stable airway access without the need for laryngoscopy which have been studied as an alternative to face masks and endotracheal tubes in the initial stages of neonatal resuscitation. A meta-analysis found that LM is a safe and more effective alternative to face mask ventilation in neonatal resuscitation. LM is recommended as an alternative secondary airway device for the resuscitation of infants > 34 weeks by the International Liaison Committee on Resuscitation. It is adopted by various national neonatal resuscitation guidelines across the globe. Recent good-quality randomized trials have enhanced our understanding of the utility of laryngeal masks in low-resource settings. Nevertheless, LM is underutilized due to its variable availability in delivery rooms, providers’ limited experience, insufficient training, preference for endotracheal tube, and lack of awareness.

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Airway management using LMA-evaluation of three insertional techniques-a prospective randomised study

Cited by 4 publications

References 14 publications

Evaluation of four techniques to administer laryngeal mask airway

Evaluation of four techniques to administer laryngeal mask airway

Conditions for Insertion of the Laryngeal Mask Airway in an Innovative Method vs the Classic Method

Laryngeal Masks in Neonatal Resuscitation—A Narrative Review of Updates 2022

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