Comparison of the oropharyngeal leak pressure between three second generation supraglottic airway devices during laparoscopic surgery in pediatric patients

Kumar, Ajeet; Sinha, Chandni; Kumar, Neeraj; Kumar, Ajeet; Kumar, Bindey; Kumar, Amarjeet; Kumar, Rajesh

doi:10.1111/pan.14447

Cited by 4 publications

(5 citation statements)

References 20 publications

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“…A systematic review and meta-analysis of randomized controlled trials comparing SADs with ETTs was conducted by Bandyopadhyay et al They stated that for short pediatric laparoscopic procedures, the SAD could be an alternative to the ETT and reduced the incidence of postoperative sore throat and accelerated postoperative recovery [91]. In pediatric laparoscopic surgery, I-gel may be a better choice in cases of higher ventilation pressure [92]. However, a randomized controlled trial showed a higher likelihood of vocal cord injury when using I-gel compared to air-Q [93].…”

Section: Special Patientsmentioning

confidence: 99%

Supraglottic airway devices: a powerful strategy in airway management

Zhang

2024

Am J Cancer Res

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The escalating airway management demands of cancer patients have prompted us to continually curate airway devices, with supraglottic airway devices (SADs) playing a significant role in this regard. SADs serve as instrumental tools for maintaining an open upper airway. Since the inception of the earliest SADs in the early 1980s, an array of advanced and enhanced second-generation devices have been employed in clinical settings. These upgraded SADs integrate specific features designed to enhance positive-pressure ventilation and mitigate the risk of aspiration. Nowadays, they are extensively used in general anesthesia procedures and play a critical role in difficult airway management, pre-hospital care, and emergency medicine. In certain situations, SADs may be deemed a superior alternative to endotracheal tube (ETT) and can be employed in a broader spectrum of surgical and nonsurgical cases. This review provides an overview of the current evidence, a summary of classifications, relevant application scenarios, and areas for improvement in the development or clinical application of future SADs.

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Section: Special Patientsmentioning

confidence: 99%

Supraglottic airway devices: a powerful strategy in airway management

Zhang

2024

Am J Cancer Res

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“…3 However, supraglottic airway devices (SGAs) are being increasingly used for laparoscopic surgery in adult and pediatric surgical patients, with varying clinical performance characteristics. [4][5][6] SGAs have shown to offer several advantages over conventional tracheal intubation including improved intraoperative hemodynamic stability, reduced perioperative respiratory complications, decreased impairment of muco-ciliary clearance, and lesser requirement of anesthetics. 7 However, despite these potential benefits, the use of SGAs during pediatric laparoscopic surgery is not without problems.…”

Section: Introductionmentioning

confidence: 99%

“…For these reasons, intubation with a tracheal tube (TT) and controlled ventilation is the gold standard for airway management strategy during general anesthesia for laparoscopic surgeries 3 . However, supraglottic airway devices (SGAs) are being increasingly used for laparoscopic surgery in adult and pediatric surgical patients, with varying clinical performance characteristics 4–6 . SGAs have shown to offer several advantages over conventional tracheal intubation including improved intraoperative hemodynamic stability, reduced perioperative respiratory complications, decreased impairment of muco‐ciliary clearance, and lesser requirement of anesthetics 7 .…”

Section: Introductionmentioning

confidence: 99%

Supraglottic airway device versus tracheal tube for pediatric laparoscopic surgery—A systematic review and meta‐analysis

Bandyopadhyay

Puri

Ashok

2023

Pediatric Anesthesia

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BackgroundConventionally, tracheal tubes have been used for general anesthesia in pediatric laparoscopic surgeries. Recently, supraglottic devices are being used for the same. The performance of supraglottic devices versus tracheal tubes in children undergoing laparoscopic surgery is uncertain.MethodsA systematic review and meta‐analysis of randomized controlled trials that compared supraglottic devices versus tracheal tubes in patients ≤18 years undergoing laparoscopic surgery under general anesthesia was conducted. The outcomes were peak airway pressures (cm H2O), end‐tidal carbon dioxide during pneumoperitoneum (mm Hg), recovery time (min), postoperative sore throat and adverse events. Mean difference and odds ratio, with 95% confidence intervals were reported using a random effect model.ResultsEight trials (n = 591) were included in the final meta‐analysis. There was no statistically significant difference in the peak airway pressures (MD 0.58, 95% CI: −0.65 to 1.8; p = .36) and end‐tidal carbon dioxide (MD −0.60, 95% CI: −2.00 to 0.80; p = .40) during pneumoperitoneum in the supraglottic device and the tracheal tube group. The tracheal tube group had higher odds of sore throat (OR 3.30, 95% CI: 1.69–6.45; p = .0005) and the supraglottic airway group had faster recovery time (MD 4.21, 95% CI: 3.12–5.31; p < .0001), which were statistically significant. The certainty of evidence is graded low.ConclusionThere is low quality evidence to suggest that for pediatric laparoscopic surgeries of short duration, supraglottic devices could provide comparable intraoperative ventilation in terms of peak airway pressures and end tidal carbon dioxide, with lower odds of postoperative sore throat and faster recovery time when compared to tracheal tubes.

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“…Supraglottic airways (SGAs) have been shown to be a safe alternative to endotracheal intubation in pediatric subumbilical laparoscopic surgical procedures (1)(2)(3)(4). Improvement of surgical conditions is also particularly important in pediatric laparoscopic surgery involving a SGA (4).…”

Section: Introductionmentioning

confidence: 99%

Effect of epidural block on surgical conditions during pediatric subumbilical laparoscopic surgery involving a supraglottic airway: a randomized clinical trial

Wu,

Wei,

Xiang

et al. 2023

Front. Med.

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BackgroundFew studies have examined the effect of epidural block on surgical conditions during pediatric subumbilical laparoscopic surgery involving a supraglottic airway (SGA). This study investigated the surgical condition scores for such procedures in cases where neuromuscular block, epidural block, or neither was used.MethodsA total of 150 patients aged 3–12 years undergoing laparoscopic orchiopexy with a ProSeal SGA device were randomly allocated to one of three groups: the control group (did not receive neuromuscular block and epidural block), the NMB group [received a neuromuscular block (train-of-four 1–2 twitches) using rocuronium], or the EDB group (received an epidural block using ropivacaine). The primary outcome was the quality of surgical conditions evaluated with the Leiden-Surgical Rating Scale by the blinded surgeon. The secondary outcome measures included intraoperative hemodynamic data (including mean arterial pressure and heart rate), the SGA device removal time, the PACU discharge time, the pain score in the PACU and intraoperative adverse events (including bradycardia, hypotension, peak airway pressure > 20 cmH2O, and poor or extremely poor surgical conditions occurred during the operation). Statistical analysis was performed with one-way analysis of variance, the Kruskal–Wallis test, the chi-square test or Fisher’s exact test. Bonferroni corrections for multiple comparisons were made for primary and secondary outcomes.ResultsSurgical condition scores were significantly higher in the NMB and EDB groups than in the control group (median difference: 0.8; 95% confidence interval [CI], 0.5–1.0; p < 0.0001; and median difference: 0.7; 95% CI, 0.5–0.8; p < 0.0001, respectively). Blood pressure and heart rate were significantly lower in the EDB group than in the other two groups (p < 0.0001 and p = 0.004). Patients in the EDB group had significantly lower pain scores during PACU than those in the other two groups (p < 0.0001). The sufentanil dose was lower in the EDB group than in the other two groups (p = 0.001).ConclusionEpidural block can improve surgical conditions during pediatric subumbilical laparoscopic surgery involving a SGA to a degree comparable to that with moderate neuromuscular block.

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Comparison of the oropharyngeal leak pressure between three second generation supraglottic airway devices during laparoscopic surgery in pediatric patients

Cited by 4 publications

References 20 publications

Supraglottic airway devices: a powerful strategy in airway management

Supraglottic airway devices: a powerful strategy in airway management

Supraglottic airway device versus tracheal tube for pediatric laparoscopic surgery—A systematic review and meta‐analysis

Effect of epidural block on surgical conditions during pediatric subumbilical laparoscopic surgery involving a supraglottic airway: a randomized clinical trial

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