Efficacy Of Laryngeal Mask Airway Research Articles

Efficacy of Laryngeal Mask Airway Compared to Endotracheal Tube: A Randomized Clinical Trial

BackgroundIn patients under general anesthesia, the laryngeal mask airway (LMA) is a valuable alternative to endotracheal intubation to maintain the airway. In this study, we compared the efficacy of LMA with an endotracheal tube (ETT) in plastic and reconstructive surgeries over 2 h on thorax and abdomen under general anesthesia in Hazrat Fatemeh Hospital in Tehran, Iran, in 2020.MethodsThis randomized clinical trial was performed on a sample size of 80, randomly assigned to two groups. The main variables included the ease of placement, recurrent carbon dioxide content, arterial oxygen saturation, and laryngeal and tracheal spasm. In addition, the sub-variables entailed the mean duration of anesthesia, nausea and vomiting, sore throat, and abdominal distension. The obtained data were analyzed by the SPSS software version 25.ResultsIn the present study, 76 patients were female. Mean age, recurrent carbon dioxide, arterial oxygen saturation, laryngeal and tracheal spasm, the mean duration of anesthesia, nausea and vomiting, sore throat, and abdominal distension were not significantly different between the two groups.ConclusionsThe results of this study showed that the classic laryngeal mask could be used as a means of airway control in general anesthesia for long-term surgeries of more than 2 h.

Comparison of Efficacy of Laryngeal Mask Airway and Intersurgical-Gel Supraglottic Airway Device During General Anesthesia in a Tertiary Care Hospital

Background: Upper airways collapse during anesthesia is a common issue faced by anesthetists. Air way maintenance is an essential component of general anesthesia. Laryngeal mask airway and Intersurgical-gel (i-gel) air way devices are new advances in general anesthesia. Present study aims to compare the ease of insertion and hemodynamic response of i-gel supraglottic and laryngeal mask airway (LMA).
 Material and Methods: A Randomized Clinical trial was conducted at the Department of Anesthesia, Shaikh Zayed Hospital, Lahore. Study duration was 6 months (June 2014- December 2014). A total of 60 patients were selected through non-probability consecutive sampling. Ethical approval was taken from ethical review board of Sheikh Zayed Hospital and informed written consents were taken from all the participants. Patients were randomly divided into two groups using lottery method. Group A was given laryngeal mask airway device while group B patients were provided with i-gel supraglottic device during anesthesia. Patients were compared for ease of insertion and hemodynamic parameters. Data was analyzed using SPSS version 24. Chi-square and t-test were applied and p-value ≤0.05 was considered statistically significant.
 Results: A total of 60 patients were included in study. Mean age of patients was 35.2±11.7 years in LMA group and 36.7±13 years in i-gel group. Group B had lower number of insertion attempts (p=0.01) and high insertion satisfaction (p=0.4) as compared to group A. However, process failure and bleeding rate was found to be slightly higher in group B (16% and 13% respectively) as compared to group A (p>0.05).
 Conclusion: i-gel supraglottic device is a successful alternative option in terms of ease of insertion and less hemodynamic response as compared to laryngeal mask airway during general anesthesia.
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Efficacy of laryngeal mask airway for airway management during surgical correction of congenital heart disease in pediatric patients with airway stenosis

Objective To evaluate the efficacy of laryngeal mask airway (LMA)for airway management during surgical correction of congenital heart disease in the pediatric patients with airway stenosis. Methods Sixteen pediatric patients of both sexes with airway stenosis, of American Society of Anesthesiologists physical statusⅠor Ⅱ, aged 4 months-5 yr, weighing 6-14 kg, scheduled for elective surgical correction of congenital heart disease under cardiopulmonary bypass, were enrolled.LMA was inserted, and combined intravenous-inhalational anesthesia was performed in all the pediatric patients.The time of LMA insertion, and airway resistance and air leakage of LMA at 20 min of mechanical ventilation were recorded.At 5 min after LMA insertion (T1), 10 min after termination of cardiopulmonary bypass (T2), and 5 min after removal of LMA (T3), blood gas analysis was performed, and the pH value, partial pressure of arterial carbon dioxide and lactic acid level were recorded.The indices such as the time of removal of LMA, damage to the laryngeal mucosa during removal of LMA, occurrence of postsurgical re-intubation, nausea and vomiting, and regurgitation of gastric contents, duration of intensive care unit stay, and postsurgical discharge time were recorded. Results Five cases with airway stenosis were confirmed by computed tomography before surgery, and 11 cases with airway stenosis were found when intubated during surgery.The time of LMA insertion was(1.3±0.4) min, and no air leakage was observed after LMA insertion.The airway resistance was (15±4)cmH2O at 20 min of mechanical ventilation.All the pediatric patients were extubated successfully, the time of extubation was(8.1±1.3)min, and the damage to the laryngeal mucosa, nausea and vomiting, and regurgitation of gastric contents were not observed.The duration of intensive care unit stay was 20 (31)h, postsurgical discharge time was 7 (1)d, and no patients required re-intubation after surgery.Compared with the value at T1, the pH value was significantly decreased at T3, partial pressure of arterial carbon dioxide was significantly increased at T2, 3, and the lactic acid level was significantly increased at T2 (P<0.05=. Conclusion LMA can be safely and effectively used for airway management during surgical correction of congenital heart disease in the pediatric patients with airway stenosis. Key words: Laryngeal masks; Heart defects, congenital; Airway obstruction; Respiration, artificial

Multicenter randomized controlled clinical trial of the efficacy of laryngeal mask airway during neonatal resuscitation

Objective To determine the feasibility,efficacy and safety of the laryngeal mask airway(LMA) ventilation in neonatal resuscitation.Methods Newborns weighing ≥ 2 000 g or delivered at ≥ 34 weeks gestation,who needed positive pressure ventilation,born between April 1,2012 and November 30,2013,in six tertiary hospitals of Guangdong Province,China,were enrolled.According to the parity of their birth date,neonates with a heart rate ≥ 60 beats per minute after initial resuscitation within 30 s,were randomly divided into laryngeal mask ventilation group 1 (LMA1 group,238 cases) and bag-mask ventilation group (BMV group,274 cases).Neonates with a heart rate ＜60 beats per minute were randomly divided into laryngeal mask ventilation group 2 (LMA2 group,85 cases) and endotracheal intubation ventilation group (ETT group,71 cases).The efficacy and adverse events among the groups were compared with t test,rank-sum test and x2 test.Results In the LMA 1 group,the successful insertion rate of the LMA at the first attempt was 95.3％ (227/238) and the insertion time was (7.0±0.7) s.Compared with the BMV group,the LMA1 group had a higher successful resuscitation rate [96.6％ (230/238) vs 79.6％ (218/274),x2=33.96,P=0.00] and shorter response time [(14.6±2.5) s vs (18.3±5.3) s,t=-9.79,P=0.00] and ventilation time [36.4 s (29.7-40.2 s) vs 50.2 s (40.3-63.3 s),Z=12.23,P=0.00].Compared with the ETT group,insertion time [(6.8±0.7) s vs (8.0±0.9) s,t=-9.45,P=0.00] and ventilation time [164.6 s (154.3-174.0 s) vs 173.4 s (162.3-185.2 s),Z=3.16,P=0.00] were shorter in the LMA2 group (all P＜0.05).There were no significant differences in heart rate before resuscitation and 1,2,3 and 5 min after fetal head delivery between the LMA1 and BMV groups (all P＞0.05),but transcutaneous oxygen saturation (SpO2) at 1,2,3 and 5 min after fetal head delivery was higher in the LMA1 group [(51.5±6.3) ％ vs (48.3±7.9) ％,t=2.45; (72.1 ±3.9) ％ vs (70.1 ±4.7) ％,t=2.62; (76.2±3.4) ％ vs (74.3±5.1) ％,t=3.04; (87.7±9.4) ％ vs (84.5±3.4) ％,t=5.31; all P＜0.05].There were no significant differences between the LMA2 and ETT groups in heart rate and SpO2 before and after resuscitation (all P＞0.05).Blood gas,lactic acid,and glucose levels before and after resuscitation showed no significant differences between the LMA1 and BMV groups,neither between the LMA2 and ETT groups (all P＞0.05).There were no significant differences in the incidence of adverse events between the LMA1 and BMV groups [3.4％ (8/238) vs 5.1％ (14/274),x2=1.02,P=0.31],and between the LMA2 and ETT groups [3.5％ (3/85) vs 2.8％ (2/71),x2=0.00,P=1.00].Conclusions LMA ventilation is safe,effective and easy to implement for the resuscitation of neonates with a gestational age ≥ 34 weeks or birth weight ≥ 2 000 g. Key words: Positive-pressure respiration; Laryngeal masks; Resuscitation; Infant, newborn; Randomized controlled trial

Efficacy of laryngeal mask airway for airway management in an experimental piglet model

Objective To evaluate the efficacy of laryngeal mask airway (LMA) for airway management in an experimental piglet model.Methods Seventy-two male piglets,aged 2-3 months,weighing 22-32 kg,were randomly divided into 2 groups (n =36 each):tracheal intubation group (group TI) and LMA group.LMA ProSeal size 4# was placed after induction of anesthesia in group LMA.Endotracheal tube size 7.0# was placed after induction of anesthesia in group TI.Each piglet underwent 1.5 h of intermittent positive pressure ventilation.VT =8-10 ml/kg,RR =16 bpm,I∶ E =1.0∶ 1.5,FiO2 =50％,FGF =3 L/min,and partial pressure of end-tidal carbon dioxide was maintained at 35-45 mm Hg.Anesthesia was maintained with iv infusion of propofol 15 mg· kg-1·h-1 and remifentanil 40 μg· kg-1 · h-1 and intermittent iv boluses of vecuronium 0.1 mg/kg.The intubation time and success rate of intubation at first attempt were recorded.Before intubation or inserting LMA,after successful intubation or LMA placement,and immediately after removal of the endotracheal tube or LMA,SpO2 was recorded and arterial blood samples were collected for blood gas analysis.The injury to throat and flatulence were recorded.Results Compared with group TI,the intubation time was significantly shortened,and the success rate of intubation at first attempt,SpO2 and PaO2 were increased,and the incidence of injury to throat and PaCO2 were decreased in LMA group (P ＜ 0.05).SpO2 was ＞ 95％ and PaO2 ＞ 150 mm Hg during ventilation in both groups.Conclusion The LMA ProSeal can provide adequate ventilation with fewer complications and can be conveniently,safely and effectively used in an experimental piglet model. Key words: Laryngeal masks; Intubation, intratracheal; Respiration, artificial

Clinical analysis of laryngeal mask airway anesthesia and endotracheal intubation anesthesia

Objective To study the safety and efficacy of laryngeal mask airway(LMA) used in breast cancer general anesthesia. Methods Forty ASA Ⅰ or Ⅱ patients with breast cancer scheduled for selective radical mastectomy under general anesthesia were allocated randomly to either laryngeal mask airway group(group A,n =20) or tracheal tube group(group B, n = 20). SBP, DBP, HR, SpO2 of patients before anesthesia(To)/after intubation immediately (T1) and 5 minutes(T2) after intubation tracheal tube or laryngeal mask intubation/after extubation immediately (T3) and 5 minutes(T4) of after extubation tracheal tube or laryngeal mask were recorded. The different incidence of anesthetic complications and side effect were observed in both groups because intubation and extubation. Results In group B, SBP, DBP and HR were significantly higher than those in group A at T1 and T3 (P ＜ 0.05). Agitation, bucking and pharyngodynia incidence rate in group B were significantly higher than group A(P ＜ 0.05). Conclusion Ventilation with LMA in patients underwent breast cancer radical correction was better than endotracheal intubation general anesthesia in keeping stable hemodynamics and producing less anesthetic complications. Key words: Laryngeal mask airway; General anesthesia; Breast cancer radical correction

NEONATAL RESUSCITATION

Background: The key to success in newborn resuscitation is theknowledge about the neonatal physiology and adequate preparation of the staff involved in the resuscitation process.The pulmonary part of the resuscitation can be accomplished with either Endotracheal Tube (ETT) or Face Mask (FM),both of these techniques require expertise and are associated with high rates of failure. Hence a third potential optionhas been suggested to overcome these problems. Objectives: To evaluate the efficacy of Laryngeal Mask Airway(LMA) in neonatal resuscitation and artificial ventilation and to compare it with that of ETT and FM. To evaluate LMA’sefficiency in situation where endotracheal intubation and facemask ventilation is difficult or not possible. Design: A Noninterventional, analytical / comparative study Setting: Combined Military Hospital Rawalpindi. Period: 20 weeks (1stJanuary 2002 to 31 May 2002). Subjects: A group of 75 neonates born with C-Section were selected on the basis ofnon-probability convenience sampling. They were subdivided into three sub gps with 25 neonates in each sub gp.Interventions; 75 neonates born after C-Section, were divided into sub gps i.e. A, B, and C containing a no of 25neonates in each gp. They were ventilated with ETT, FM and LMA respectively. These newborn babies had an Apgarscore &lt; 4. They were resuscitated using a fix protocol. The efficacy of ventilation with either technique was evaluatedin terms of placement and ventilation. Results: The LMA emerged, as a valuable and better option in newbornresuscitation. Moreover, it was a successful tool in situations where endotracheal intubation and facemask ventilationwas difficult or impossible. Conclusion: The LMA is a potential valuable adjunct for the management of neonatalairway.