Safety and efficacy of laryngeal mask airway ventilation in obese patients with airway stenosis

Pourciau, Dusty Cole; Hotard, D. Peter; Hayley, Schuylor; Hayley, Kasey; Sutton, Collin; McWhorter, Andrew J.; Fink, Daniel

doi:10.1002/lary.26684

Cited by 6 publications

(7 citation statements)

References 14 publications

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“…Some reports have described the risk factors for LMA insertion failure. [17][18][19] Ramachandran et al 17 performed a prospective study of 15,795 adult patients in whom an LMA was used for general anesthesia. They studied the whole process of anesthesia with the LMA, including the insertion and maintenance of ventilation, to explore the risk factors for LMA insertion failure.…”

Section: Discussionmentioning

confidence: 99%

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Predictive risk factors of failed laryngeal mask airway insertion at first attempt

Wang

Shi

et al. 2018

J Int Med Res

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ObjectivesA failed first attempt at laryngeal mask airway (LMA) insertion could increase the risk of laryngospasm, hypoxemia, and postoperative sore throat. This study was performed to investigate the risk factors for failed first-attempt LMA placement.MethodsIn total, 461 patients who underwent general anesthesia with a Supreme LMA (Teleflex Medical, Shanghai, China) and who had an American Society of Anesthesiologists (ASA) physical status of I to III were prospectively enrolled. The LMA was inserted after anesthetic induction. We recorded the insertion conditions and each patient’s age, ASA status, body weight, body mass index (BMI), duration of anesthesia, size of LMA, and cuff pressure; the years of work experience of the anesthesiologists; and the use or nonuse of lidocaine gel as a lubricant.ResultsSuccessful first-attempt placement of the Supreme LMA was achieved in 438 (95.10%) patients, while first-attempt placement failed in 23 (4.99%). Significant risk factors for failure of first-attempt LMA insertion included high age, high body weight, BMI of <20 kg/m2, and insertion without using lidocaine gel.ConclusionsA patient age of >61 years, high body weight, BMI of <20 kg/m2, and insertion without lidocaine gel could significantly increase the risk of failed first-attempt Supreme LMA insertion.

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Section: Discussionmentioning

confidence: 99%

“…Some reports have described the risk factors for LMA insertion failure. 17–19 Ramachandran et al. 17 performed a prospective study of 15,795 adult patients in whom an LMA was used for general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Predictive risk factors of failed laryngeal mask airway insertion at first attempt

Wang

Shi

et al. 2018

J Int Med Res

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“…Most studies focus on ventilation comparing laryngeal mask airway versus endotracheal intubation as airway device used during percutaneous tracheostomy, but none compares hemodynamic parameters [3,4,5]. Some studies assess the effi cacy of laryngeal mask airway (LMA) ventilation in patients with airway stenosis [6] and report no major or minor complications. Our team also reported a cricotracheal resection in a case of subglottic stenosis with a lumen of Fig.…”

Section: Discussionmentioning

confidence: 99%

Laryngeal Mask Ventilation during Tracheostomy Improves Intraoperative Hemodynamic Stability in Patients Undergoing Total Laryngectomy

Marinov

Popov

Belitova

2019

Acta Medica Bulgarica

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Background and objectives: Laryngectomy with extensive extirpational neck dissection is still the treatment of choice for patients with advanced laryngeal cancer. During the initial part of laryngectomy – tracheostomy, there is a significant upper airway obstruction, caused by the cancer process itself and worsened by surgical pressure and manipulation during creation of tracheostomy. This study aims to make comparative assessment of the patient’s hemodynamic parameters, operated using three of the most popular approaches during tracheostomy: local anesthesia with preserved spontaneous ventilation; general anesthesia with ventilation by endotracheal intubation and general anesthesia with ventilation by laryngeal mask airway. Methods: A prospective cohort study was conducted in a tertiary referral center. Sixty patients with advanced laryngeal cancer appointed for total laryngectomy, were enrolled in the study. They were randomly assigned into three groups, according to the ventilation method used during the tracheostomy. Results: Patients who underwent tracheostomy under local anesthesia displayed statistically the highest levels of SAP, DAP, MAP and heart rate intraoperatively. The group of patients who underwent tracheostomy with endotracheal intubation, also displayed significantly higher levels of hemodynamic parameters during the procedure compared with the group with laryngeal mask airway ventilation, despite the fact that both groups were under general anesthesia. Conclusions: To our knowledge, this is the first study to demonstrate that laryngeal mask ventilation during tracheostomy improves intraoperative hemodynamic stability in patients undergoing total laryngectomy compared to endotracheal intubation.

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“…Moreover Schieren and associates 13 reported no perioperative anesthesia-related complications in a series of 10 patients receiving cervical tracheal resection using laryngeal mask ventilation. Pourciau and coworkers 14 assessed the feasibility of laryngeal mask ventilation in a cohort of 14 obese patients with a mean body mass index of 38 kg/m 2 (range, 25-54) and airway stenosis. All patients could be sufficiently ventilated, and no patient required endotracheal intubation.…”

Section: Commentmentioning

confidence: 99%

Laryngeal Mask as the Primary Airway Device During Laryngotracheal Surgery: Data From 108 Patients

Schweiger

Rodrigues

Roesner

et al. 2020

The Annals of Thoracic Surgery

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Safety and efficacy of laryngeal mask airway ventilation in obese patients with airway stenosis

Abstract: 4. Laryngoscope, 127:2582-2584, 2017.

Cited by 6 publications

References 14 publications

Predictive risk factors of failed laryngeal mask airway insertion at first attempt

Predictive risk factors of failed laryngeal mask airway insertion at first attempt

Laryngeal Mask Ventilation during Tracheostomy Improves Intraoperative Hemodynamic Stability in Patients Undergoing Total Laryngectomy

Laryngeal Mask as the Primary Airway Device During Laryngotracheal Surgery: Data From 108 Patients

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