Oropharyngeal leak pressure with the laryngeal mask airway Supreme™ at different intracuff pressures: a randomized controlled trial

Zhang, Lianfeng; Seet, Edwin; Mehta, Vanita; Subramanyam, Rajeev; Ankichetty, Saravanan P; Wong, David T.; Chung, Frances

doi:10.1007/s12630-011-9514-6

Cited by 54 publications

(54 citation statements)

References 17 publications

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“…Oropharyngeal leak pressure is the pressure at which a gas leak occurs around the LMA cuff. Oropharyngeal leak pressure in LMA Supreme at intracuff pressure of 60 cmH 2 O is reported to be approximately 20 cmH 2 O, similar to that in our case [20]. By any chance, rigid airway tube might have caused adverse effect.…”

Section: Discussionsupporting

confidence: 84%

Unilateral Hypoglossal Nerve Palsy after Use of the Laryngeal Mask Airway Supreme

Takahoko

Iwasaki

Sasakawa

et al. 2014

Case Reports in Anesthesiology

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Purpose. Hypoglossal nerve palsy after use of the laryngeal mask airway (LMA) is an exceptionally rare complication. We present the first case of unilateral hypoglossal nerve palsy after use of the LMA Supreme. Clinical Features. A healthy 67-year-old female was scheduled for a hallux valgus correction under general anesthesia combined with femoral and sciatic nerve blocks. A size 4 LMA Supreme was inserted successfully at the first attempt and the cuff was inflated with air at an intracuff pressure of 60 cmH2O using cuff pressure gauge. Anesthesia was maintained with oxygen, nitrous oxide (67%), and sevoflurane under spontaneous breathing. The surgery was uneventful and the duration of anesthesia was two hours. The LMA was removed as the patient woke and there were no immediate postoperative complications. The next morning, the patient complained of dysarthria and dysphasia. These symptoms were considered to be caused by the LMA compressing the nerve against the hyoid bone. Conservative treatment was chosen and the paralysis recovered completely after 5 months. Conclusion. Hypoglossal nerve injury may occur despite correct positioning of the LMA under the appropriate intracuff pressure. A follow-up period of at least 6 months should be taken into account for the recovery.

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Section: Discussionsupporting

confidence: 84%

Unilateral Hypoglossal Nerve Palsy after Use of the Laryngeal Mask Airway Supreme

Takahoko

Iwasaki

Sasakawa

et al. 2014

Case Reports in Anesthesiology

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“…Van Zundert et al (1) report that the increased OLP values with S-LMA are associated with the increase of intracuff pressures. Yet another study asserts that with the S-LMA, higher leak pressures are obtained at high intracuff pressures (12). On the contrary, despite the increased intracuff pressures during surgery, OLP did not increase in our previous study (3).…”

Section: Discussionmentioning

confidence: 53%

Comparison of Supreme Laryngeal Mask Airway and ProSeal Laryngeal Mask Airway during Laparoscopic Cholecystectomy

Hoşten¹,

Yıldız²,

Kuş³

et al. 2012

Balkan Med J

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Objective: This study compared the safety and efficacy of the Supreme Laryngeal Mask Airway (S-LMA) with that of the ProSeal-LMA (P-LMA) in laparoscopic cholecystectomy.Material and Methods: Sixty adults were randomly allocated. Following anaesthesia induction, experienced LMA users inserted the airway devices.Results: Oropharyngeal leak pressure was similar in groups (S-LMA, 27.8±2.9 cmH20; P-LMA, 27.0±4.7 cmH 2 0; p=0.42) and did not change during the induction of and throughout pneumoperitoneum. The first attempt success rates were 93% with both S-LMA and P-LMA. Mean airway device insertion time was significantly shorter with S-LMA than with P-LMA (12.5±4.1 seconds versus 15.6±6.0 seconds; p=0.02). The first attempt success rates for the drainage tube insertion were similar (P-LMA, 93%; S-LMA 100%); however, drainage tubes were inserted more quickly with S-LMA than with P-LMA (9.0±3.2 seconds versus 14.7±6.6 seconds; p=0.001). In the PACU, vomiting was observed in five patients (three females and two males) in the S-LMA group and in one female patient in the P-LMA group (p=0.10).Conclusion: Both airway devices can be used safely in laparoscopic cholecystectomies with suitable patients and experienced users. However, further studies are required not only for comparing both airway devices in terms of postoperative nausea and vomiting but also for yielding definitive results.

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“…However, it was reported that increasing the intracuff pressure to 80cm H20 favourably increases the OLP without an increase in the incidence of postoperative airway morbidity. 23 In present study muscle relaxant was used so the effect of the pharyngeal muscle tone on OLP had no significance. The difference between the mean OLP and mean peak airway pressure at 15 minutes was higher in LMA Proseal (11.43) than I-gel (9.83) or LMA Supreme (9.05).…”

mentioning

confidence: 77%

Comparative study of various supraglottic devices with clinical and fiber optic assessment in elective laparoscopic procedures

2017

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Background: Aim of present study was to compare the efficacy and safety of supraglottic devices (LMA supreme, LMA proseal and I-Gel) by clinical and fiberoptic evaluation in elective laparoscopic surgeries under general anaesthesia with controlled ventilation.Methods: The design was a prospective, randomized study enrolling total 105 patients of either sex, (age 18-65 years), ASA grade I/II and mallampati score I and II, were randomly allocated to LS (LMAS), LP (PLMA), and IG (I-Gel) groups according to the supraglottic device applied. The three devices were compared as regards insertion parameters, adequacy of ventilation (oxygen saturation, endtidal carbon dioxide and air leak), fibreoptic vision and intra or postoperative complications.Results: The overall ease of insertion of LMAS was found to be better than the other two devices. Adequacy of ventilation was comparable in all the study groups. Safety of these devices was found to be comparable but if OLP was considered as a marker of safety of the device, LMA proseal was a better option than the other two devices. There was no significant difference in the fiberoptic view of the laryngeal inlet between the three study groups but the number of patients with grade 4 view of laryngeal inlet fiberoptic was more in I gel than LMA proseal and LMA supreme.Conclusions: It was concluded that the LMAS, PLMA and I-Gel are effective ventilatory devices during controlled ventilation, without major complications. But in clinical practice it is advisable to monitor peak airway pressure, OLP and laparoscopic view of gastric distension whenever these devices are used in laparoscopic surgeries.

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Oropharyngeal leak pressure with the laryngeal mask airway Supreme™ at different intracuff pressures: a randomized controlled trial

Cited by 54 publications

References 17 publications

Unilateral Hypoglossal Nerve Palsy after Use of the Laryngeal Mask Airway Supreme

Unilateral Hypoglossal Nerve Palsy after Use of the Laryngeal Mask Airway Supreme

Comparison of Supreme Laryngeal Mask Airway and ProSeal Laryngeal Mask Airway during Laparoscopic Cholecystectomy

Comparative study of various supraglottic devices with clinical and fiber optic assessment in elective laparoscopic procedures

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