Intubating laryngeal mask airway as an independent ventilatory and intubation device. A comparison between supine, right lateral and left lateral

Panwar, Mamta; Bharadwaj, Avnish; Chauhan, Gayatri; Kalita, Drubajyoti

doi:10.4097/kjae.2013.65.4.306

Cited by 12 publications

(22 citation statements)

References 18 publications

(20 reference statements)

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“…Previous studies have shown that tracheal intubation in lateral position can be difficult. [ 1 2 ] Several studies have shown successful ventilation in lateral position with the laryngeal mask airway,[ 3 ] ventilation and intubation in the lateral position with the intubating laryngeal mask airway[ 4 ] with and without the aid of a lightwand,[ 5 ] intubation with the lightwand,[ 6 ] and fiberoptic intubation. [ 7 ] However, newer videolaryngoscopes like C-MAC have not been formally evaluated for tracheal intubation in laterally positioned patient.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Macintosh laryngoscope and C-MAC video laryngoscope for intubation in lateral position

Bhat

Sanickop

Patil

et al. 2015

J Anaesthesiol Clin Pharmacol

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Background and Aims:Endotracheal intubation is conventionally performed when the patient is in supine position. It may be required to secure airway in laterally positioned patient. Tracheal intubation in lateral position seems to be difficult because the laryngeal view is compromised. Hence, C-MAC video laryngoscope (Karl Storz, Germany), a newer device using a modified macintosh blade may be useful for intubation in lateral position.Material and Methods:A total of 100 American Society of Anesthesiologists Grade I and II patients, randomly allotted to C-MAC or direct laryngoscopy group. Patients with difficult airway were excluded. After induction of anesthesia, patient was put in right-lateral position and intubation was carried out by consultant who is well-versed in using C-MAC laryngoscope. Time for intubation, number of attempts, Modified Cormack – Lehane grade, mucosal injury, and external laryngeal manipulation applied were noted.Statistical Analysis:Demographics and baseline airway assessments were analyzed using summary statistics. Unpaired t-test was used to assess intubation time. Number of attempts, esophageal intubation, dental injury, mucosal injury, use of stylet, and application of external laryngeal manipulation were analyzed using Chi-square test.Results:Overall intubation success rate was 100%. The time taken in C-MAC group was 24.8 ± 8.5 s and in direct group was 33.8 ± 9.12 s. The number of intubation attempts was not significant. Cormack – Lehane grade was better with C-MAC laryngoscope. Mucosal injury and use of external laryngeal manipulation was more in direct group.Conclusion:C-MAC is better than Macintosh laryngoscope for intubation in lateral position.

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Section: Introductionmentioning

confidence: 99%

Comparison of Macintosh laryngoscope and C-MAC video laryngoscope for intubation in lateral position

Bhat

Sanickop

Patil

et al. 2015

J Anaesthesiol Clin Pharmacol

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“…The data comparing ETTs and SADs with regards to insertion and extubation time vary in particular when comparing different types of surgery [29,30], and it has been shown that there is a significantly shorter time to home-readiness when LMAs are used [29]. In addition, success rates of ''intubation'' with LMAs have been shown to be over 90 % and can be done in the supine, left-lateral, and right-lateral positions with similar results [31].…”

Section: The Supraglottic Airwaymentioning

confidence: 98%

Airway Management in Ambulatory Anesthesia

Gormley

Mannion

2014

Curr Anesthesiol Rep

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Ambulatory surgery numbers are rising in the United States at a rapid pace. Between 1996 and 2006, procedures carried out in free-standing surgical centers rose by 300 %. Airway management is a key factor in time management, patient safety, and cost-effectiveness. For the anesthesiologist practicing in a free-standing or officebased unit, patient selection and preparation for all eventualities are essential. A combination of traditional skills and advances in technology and anesthetic research are discussed to outline what we believe is a guide to safe anesthetic practice and airway management in the ambulatory setting. Pre-assessment of the patient, the management of the uncomplicated airway, and management of the anticipated and unanticipated difficult airway are discussed in this article.

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“…A previous study reported one case of accidental esophageal intubation while using Aura-i as a conduit for tracheal intubation [13]. One previous study reported accidental extubation during their study [6]. No significant difference was reported in hemodynamic parameters in both the groups.…”

Section: Discussionmentioning

confidence: 79%

“…A previous study showed that ILMA placement was easy in 88.8% of cases, slightly difficult in 9.2%, while moderately difficult in 2% of cases but impossible in none of the cases [5]. Adjusting maneuvers used in the previous study were extension, flexion, and Chandy's maneuver for adjusting ILMA insertion for successful ILMA placement [6].…”

Section: Discussionmentioning

confidence: 93%

“…In a previous study, it was found that the overall success rate of the insertion of the device after three attempts was more with Air-Q (Mercury Medical, Clearwater, FL) (96.6%) as compared with ILMA (91.6%) but overall, it was insignificant [ 4 ]. A previous study showed that ILMA placement was easy in 88.8% of cases, slightly difficult in 9.2%, while moderately difficult in 2% of cases but impossible in none of the cases [ 5 ]. Adjusting maneuvers used in the previous study were extension, flexion, and Chandy’s maneuver for adjusting ILMA insertion for successful ILMA placement [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Fiberoptic-Guided Tracheal Intubation Through Intubating Laryngeal Mask Airway (ILMA) FastrachTM and Ambu® Aura-i™: A Randomized Clinical Study

Mishra¹,

Bharadwaj²

2020

Cureus

Self Cite

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Background and aim The primary aim of the study was to compare the intubation characteristics and effectiveness of intubating laryngeal mask airway (ILMA) and Ambu® Aura-i™ as a conduit for facilitating fiberoptic-guided intubation. Methods Eighty patients were enrolled in the randomized-controlled hospital-based study. After inducing general anesthesia, an appropriately sized ILMA (group 1)/Ambu Aura-I (group 2) was placed. Fiberoptic assessment of the glottic view was done followed by fiberoptic-guided tracheal intubation. The time taken for the insertion of ILMA/Ambu Aura-i, glottic view grading, time taken for fiberoptic-guided intubation, ease of intubation, time taken for the removal of ILMA/Ambu Aura-i were recorded. Data analysis was done using the two-tailed independent t-test, paired t-test, and Fisher's exact probability test. Result Anthropometric and airway parameters were similar in both groups. The success rate of the insertion of both devices was 100%. In group 1, the mean time taken for the insertion was 20.53±1.91, and it was 13.98±2.4 in group 2 (P<0.001S). Fiberoptic assessment of the glottic view in group 1 (ILMA group) was grade 1 in 80% of the patients, whereas it was 92% in group 2 (Ambu Aura-i) (P=0.54). The mean time taken for fiberoptic-guided intubation was 14.95±1.85 in group 1 and 14.15±1.37 in group 2 (P>0.001). No significant difference was observed according to the number of attempts in intubating through ILMA/Ambu Aura-i. Seventy-five percent (75%) in group 1 and 87.5% in group 2 were successfully inserted on the first attempt (= 0.33). The time taken for the removal of the device was 11.87 +1.265 seconds in group 1 and 11.25±1.58 seconds in group 2 (P=0.054). Conclusion The Ambu Aura-i scores superiorly over ILMA in requiring less time for successful insertion on the basis of statistical analysis and hence appears to be a better independent ventilatory device.

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Intubating laryngeal mask airway as an independent ventilatory and intubation device. A comparison between supine, right lateral and left lateral

Cited by 12 publications

References 18 publications

Comparison of Macintosh laryngoscope and C-MAC video laryngoscope for intubation in lateral position

Comparison of Macintosh laryngoscope and C-MAC video laryngoscope for intubation in lateral position

Airway Management in Ambulatory Anesthesia

Comparison of Fiberoptic-Guided Tracheal Intubation Through Intubating Laryngeal Mask Airway (ILMA) FastrachTM and Ambu® Aura-i™: A Randomized Clinical Study

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