Techniques for the insertion of the proseal laryngeal mask airway: comparison of the foley airway stylet tool with the introducer tool in a prospective, randomized study

Chen, Mao-Kai; Hsu, Hung-Te; Lu, I‐Cheng; Shih, Chih-Kai; Shen, Ya‐Chun; Tseng, Kuang‐Yi; Cheng, Kuang‐I

doi:10.1186/1471-2253-14-105

Cited by 7 publications

(11 citation statements)

References 25 publications

(32 reference statements)

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“…The use of a gum elastic bougie to guide ProSeal LMA laryngeal mask insertion has a lower incidence of sore throat when compared with the finger insertion technique , and the same holds true when using a stylet . Alternative insertion methods have not demonstrated a reduction .…”

Section: Methodsmentioning

confidence: 99%

Postoperative sore throat: a systematic review

2016

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Summary Postoperative sore throat has a reported incidence of up to 62% following general anaesthesia. In adults undergoing tracheal intubation, female sex, younger age, pre‐existing lung disease, prolonged duration of anaesthesia and the presence of a blood‐stained tracheal tube on extubation are associated with the greatest risk. Tracheal intubation without neuromuscular blockade, use of double‐lumen tubes, as well as high tracheal tube cuff pressures may also increase the risk of postoperative sore throat. The expertise of the anaesthetist performing tracheal intubation appears to have no influence on the incidence in adults, although it may in children. In adults, the i‐gel™ supraglottic airway device results in a lower incidence of postoperative sore throat. Cuffed supraglottic airway devices should be inflated sufficiently to obtain an adequate seal and intracuff pressure should be monitored. Children with respiratory tract disease are at increased risk. The use of supraglottic airway devices, oral, rather than nasal, tracheal intubation and cuffed, rather than uncuffed, tracheal tubes have benefit in reducing the incidence of postoperative sore throat in children. Limiting both tracheal tube and supraglottic airway device cuff pressure may also reduce the incidence.

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Section: Methodsmentioning

confidence: 99%

Postoperative sore throat: a systematic review

2016

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“…Post-operative sore throat was also similar between the groups and lower than reported in other studies. [ 5 6 22 ] This may be due to the shorter duration of surgery in both groups compared to these studies.…”

Section: Discussionmentioning

confidence: 88%

“…Several studies[ 5 18 22 23 ] reported the main causes of failed PLMA placement were either folding of the tip of the cuff over itself or impaction of the PLMA at the back of the mouth. In Group IT, there were failed insertions due to failed pharyngeal placement and the gastric tube not being successfully inserted through the drain tube (not seen in Group ST), showing that the tip of the PLMA was folded on itself.…”

Section: Discussionmentioning

confidence: 99%

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A novel technique for insertion of ProSeal™ laryngeal mask airway: Comparison of the stylet tool with the introducer tool in a prospective, randomised study

et al. 2017

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Background and Aims:The ProSeal™ laryngeal mask airway (PLMA) has a soft cuff which tends to fold on itself during insertion, resulting in reduced first-attempt success rate. We compared the standard introducer technique of PLMA insertion with a novel method to prevent folding of the cuff using a Rüsch™ StyletMethods:This randomised superiority trial included 120 American Society of Anesthesiologists I–II patients between 18 and 80 years, undergoing elective surgeries under general anaesthesia using a PLMA for airway management. The PLMA was inserted using the standard introducer tool in sixty patients (Group IT), while in sixty other patients, a Rüsch™ Stylet was inserted through the drain tube up to its tip. (Group ST). The primary outcome was first-attempt success rate. Secondary outcomes included overall insertion success, number of attempts, total time to successful insertion, presence of air leaks, haemodynamic response to insertion and quality of fit assessed using Brimacombe's fibre-optic scoring. Continuous variables were compared using independent t-test or Mann–Whitney U-test and categorical variables were analysed using Chi-square test or Fisher's exact test.Results:First-attempt success rate of insertion was higher in Group ST compared to Group IT (95% vs. 82%, P = 0.04). Favourable grade of placement was better in Group ST (86.7% vs. 52.5%, P < 0.001). Overall insertion success rates and haemodynamic responses were comparable between the groups.Conclusions:PLMA insertion using the stylet tool has a higher first-attempt insertion success and superior placement compared to insertion using the conventional introducer tool.

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“…Flexi-slip stylet guided insertion also showed higher success rate together with decreasing trauma complications [7]. The airway stylet; Foley airway stylet (FAST), had similar outcomes but it had the higher trauma rate compared to the metallic introducer [9]. Additionally, neuromuscular blocking agents could be used to improve the laryngeal airway insertion [11].…”

Section: Introductionmentioning

confidence: 99%

Proseal™ LMA Insertion: Comparison of the Nasogastric Catheter Guided Technique with the Conventional Digital Technique

2018

J Clin Res Med

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Several techniques have been introduced to improve the success rate and efficiency of the Proseal TM laryngeal mask airway (PLMA) placement along with decreasing complication. The aim of this study is to compare the success rate of the nasogastric catheter guided technique to the conventional digital technique. MethodsIn this randomized-controlled clinical trial, 200 patients, age between 18 and 65 years old, underwent inhalation technique anesthesia were enrolled. Participants were randomized by computer to Nasogastric catheter guided group (NG) and Digital technique group (DT). Anesthesia was induced with propofol (3 mg/kg) and fentanyl (2 mcg/kg). In DT group, the PLMA was inserted by using the index finger insertion technique. In NG group, PLMA with nasogastric catheter protruding for 5 cm from the PLMA drain tube distal aperture was inserted with the same method. Successful insertion was evaluated by the chest movement and the persistent rising of end-tidal carbon dioxide. The quality of placement was also recorded after the patient regained spontaneous breathing. Complications were evaluated at the end of the surgery and at the PACU discharge time. ResultPatient characteristics were similar in both groups. The overall insertion success rates were similar; 89.3% in NG and 81.5% in DT group (P=0.22). There was no difference in insertion attempt (success rate in the first attempt = 86.7% and 84.0% in NG group and DT group respectively, P = 1.00). The time to the success of insertion was not significantly different; 30 seconds in NG group vs 35 seconds in DT group (P=0.185). There were no differences in the complications such as airway bleeding, sore throat, dysphagia, and hoarseness. ConclusionInsertion of Proseal LMA using nasogastric catheter guided technique did not provide an advantage over digital technique. The complications from both insertion techniques were also similar.

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Techniques for the insertion of the proseal laryngeal mask airway: comparison of the foley airway stylet tool with the introducer tool in a prospective, randomized study

Cited by 7 publications

References 25 publications

Postoperative sore throat: a systematic review

Postoperative sore throat: a systematic review

A novel technique for insertion of ProSeal™ laryngeal mask airway: Comparison of the stylet tool with the introducer tool in a prospective, randomised study

Proseal™ LMA Insertion: Comparison of the Nasogastric Catheter Guided Technique with the Conventional Digital Technique

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