Tubo laríngeo com sucção descartável versus reutilizável para ventilação de pacientes submetidos à colecistectomia laparoscópica (original) (raw)
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Laryngeal Tube Suction-D, Combitube, and Proseal Laryngeal Mask Airway: Randomized Clinical Trial
Background: The Esophageal Tracheal CombitubeTM (ETC), Disposable Laryngeal Tube SuctionTM (LTS-D), and ProSeal Laryngeal Mask AirwayTM (PLMA) are devices that can secure the airway and maintain access to the stomach in at-risk patients, such as trauma or non fastened patients, when endotracheal intubation is difficult or impossible. Methods: We conducted a randomized controlled trial with the following primary endpoints: duration of intubation, successful placement on first attempt, leak pressures, and post-operative morbidity (dysphagia, sore throat). Results: The ETC (n=71), LTS-D (n=73), and PLMA (n=72) groups showed significant differences in the likelihood of successful insertion on first attempt (70.0%, 89.0%, and 72.2%, respectively), p=0.012. There was no significant difference in successful insertion rate among the ETC (90.1%), LTS-D (94.5%), and PLMA (93.1%) groups, p=0.6. Cuff pressure was significantly greater in the ETC group (284.2±63.0 cm H2O) compared to each of the LTS-D (72.0±15.7 cm H2O), and PLMA (72.3±21.7 cm H2O) groups, p<0.00001. Cuff volume was significantly greater in the ETC group (84.0±9.1 cc) compared to each of the LTS-D (64.8±12.4 cc) and PLMA (31.3±17.9cc) groups, p<0.00001, and was significantly greater in the LTS-D group compared to the PLMA group, p<0.00001. Prevalence of severe sore throat and dysphagia was greater in the ETC group compared to the other groups, both at 2 hours (p<0.003) and 24 hours (p<0.0001) after securing the airway. Conclusion: The ETC is an airway device resulting in greater cuff volume and pressure compared to LTS-D and PLMA, decreased likelihood of successful insertion on first attempt compared to LTS-D, and greater prevalence of sore throat and dysphagia compared to LTS-D and PLMA, without any significant differences in insertion time.
2018
Context: Supraglottic airway devices have been established in clinical anesthesia practice and have been previously shown to be safe and efficient. Two new supraglottic airway devices, I-gel and laryngeal suction tube-II offer potential benefits when used in elective surgical procedures. Aims: The objective of this study was to compare I-Gel with LTS II to determine device performance during general anesthesia and controlled ventilation, by comparing the ease of insertion, number, and duration of insertion attempts and complications among the two devices. Settings and Design: This study was conducted as randomized controlled study in a teaching hospital. Subjects and Methods: Sixty patients undergoing elective surgical procedures of 60-90 minutes duration were randomly divided in two groups of thirty each, I-gel (Group I) or LTS II (Group L) group. Anesthesia was induced with standard drugs and the supraglottic airway device was inserted. The following parameters were noted: hemodyn...
https://www.ijhsr.org/IJHSR\_Vol.10\_Issue.7\_July2020/IJHSR\_Abstract.045.html, 2020
Background and Aim: Several clinical studies have been performed on supraglottic airway devices to check for the advantages over the latest versions. Comparison of classic LMA (cLMA) and i-gel is yet to be explored further to optimize the use of airway devices. Methodology: A prospective randomized study was conducted for two years in a tertiary care hospital. Selected 60 patients were divided equally into two groups, C-LMA (group 1) and i-gel (group 2). Both devices were compared with respect to ease of insertion, number of attempts for insertion, airway leak pressure, hemodynamic changes and complications. Results: There was no observed statistical significance in both the groups regarding age, sex, body weight, ease of insertion, number of attempts, basal heart rate, SBP, DBP, MAP, SpO2 and adverse effects. The mean time duration of insertion was 23.2 ± 7.14 in cLMA and 16.67 ± 4.2 in i-gel which was statistically significant (p=0.001). Airway leak pressure was significantly higher in i-gel group (p=0.001) in the present study. Conclusion: Both the devices are safe and good in performance with respect to ease of insertion, hemodynamic changes and pharyngolaryngeal morbidity. Mean time duration was less for i-gel which is easier method to perform. A significant gastric insufflation was low in i-gel over c-LMA.
Journal of Evolution of Medical and Dental Sciences, 2015
We compared two supraglottic airway devices, namely, the I-gel and Laryngeal mask airway classic (LMA-c) devices, in adult patients posted for elective surgeries under general anaesthesia. MATERIAL AND METHODS: One hundred patients, scheduled for various elective surgical procedures under general anaesthesia belonging to ASA classes I and II and duration of surgery less than 1 hour. Pre-anaesthetic evaluation included assessing the general condition of the patient, airway by Mallampatti grading and rule of 1-2-3, nutritional status and body weight of the patient, and detailed examination of the Cardiovascular and the Respiratory systems and routine investigations. Primary measures were: ease of insertion, number of insertion attempts, and time for insertion, airway leak pressure, hemodynamic changes, and oxygen saturation. Secondary measures were: adverse effects such as tongue, lip or dental trauma and postoperative sore throat, dysphagia or hoarseness. OBSERVATIONS: There was no significant difference for most of the primary and secondary parameters. However, the mean duration of insertion of i-gel in group IG patients and LMA in group CL patients were 17.12±3.42 and 25.62±5.28 seconds respectively. The difference was statistically highly significant. (p<0.001). The mean airway leak pressure with i-gel in group IG patients was 26.38±2.76 9 (cm H2O) and with c-LMA in group CL patients was 19.70±2.10 (cm H2O). The difference was statistically highly significant (p<0.01). CONCLUSION: I-gel, though slightly more expensive, was a better choice with regard to ease of insertion, better airway sealing pressure and lower morbidity compared to c-LMA.
A clinical evaluation of four disposable laryngeal masks in adult patients
Journal of Clinical Anesthesia, 2008
Study Objective: To compare the clinical use of four disposable laryngeal masks (DLMs): the Ambu laryngeal mask [Ambu LM], Solus, Laryngeal Mask Airway (LMA) Unique, and Soft Seal. Design: Prospective, randomized study. Setting: Operating room and recovery area of a university-affiliated ambulatory surgery unit. Patients: 200 adult ASA physical status I, II, and III patients, scheduled for ambulatory procedures. Interventions: Patients underwent insertion of the DLM by nonexperienced residents. Measurements: The time and number of attempts needed for insertion, quality of ventilation, airway sealing pressure at 60 cmH 2 O of intracuff pressure, and complications were all evaluated.
IOSR Journals , 2019
Background And Objectives- Maintenance of airway is an integral part of general anaesthesia. Various airwaydevices are used for this purpose. Hemodynamic changes are major hazards of general anesthesia and are probably generated by direct laryngoscopy &endotracheal intubation. Supraglottic airway devices have been widely used as analternative to tracheal intubation during general anaesthesia.Laryngeal mask airway is a supraglottic airway device with an inflatable cuff forming a low pressure seal around the laryngeal inlet and permitting ventilation. Thei-gel is a novel supraglottic airway device made of thermoplastic elastomer which is soft, gel-like and transparent. Unlike the conventional LMA, it does not have an inflatable cuff.In view of this, the present study was undertaken to compare the performance oftwo supraglottic airway devices classic laryngeal mask airway and i-gel in anaesthetized, paralyzed adult patients posted for elective surgeries under general anaesthesia. Methodology-One hundred patients, scheduled for various elective surgical procedures undergeneral anaesthesia belonging to ASA class I and II were included in the study and wererandomly divided into two groups with 50 patients in each group. In Group 1 (n=50),i-gel supraglottic airway device was used and in Group 2 (n=50) classic laryngeal maskairway was used. Both the devices were compared in relation to the ease of insertion,number of insertion attempts, and time of insertion, airway leak pressure, haemodynamicchanges, intra and post-operative complications. Results-There was no statistically significant difference between the devices with respectto ease of insertion and number of attempts of insertion. The mean airway leakpressure with i-gel was significantly higher as compared with c-LMA (26.38±2.76 and19.7±2.10 cm H2O, respectively, p=0.000). The mean time of insertion for i-gel was17.12±3.42 seconds which was significantly shorter compared to c-LMA with a meaninsertion time of 25.62±5.28 seconds (p=0.000). There were no statistically significant differences in haemodynamic changes and the postoperative complications between the devices. Interpretation And Conclusion-Both i-gel and c-LMA are easy to insert and provide an effective airway duringpositive pressure ventilation, with i-gel providing a better airway sealing pressure ascompared to c-LMA.
Journal of anaesthesiology, clinical pharmacology
The Supreme laryngeal mask airway (SLMA) and the laryngeal tube suction-disposable (LTS-D), both second-generation supraglottic airway devices, have a record of efficiency when used for airway management in mechanically ventilated patients, during general anesthesia. There is no published data comparing these two devices in patients breathing spontaneously during general anesthesia. Eighty patients with normal airways undergoing elective general anesthesia with spontaneous ventilation were randomized to airway management with a SLMA or LTS-D. Efficacy and adequacy of oxygenation and ventilation were compared. No cases of desaturation of oxygen saturation (SpO) values of less than 95% occurred with either device. The mean difference for SpO between the two devices (0.7%) has no clinical significance. Slight hypercapnia was noted with both devices to acceptable values during spontaneous ventilation. Both SLMA and LTS-D are suitable and effective for airway management in patients breat...
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Supraglottic airways are airway devices for providing ventilation, oxygenation and anaesthetic gases to the patients. The SGA has revolutionised airway management because of its ease of insertion, hands-free operation, reliable airway and haemodynamic stability. The present study is conducted to compare the newer non-inflatable cuffed I-Gel with Classic LMA and Proseal LMA. Aims and Objectives-To compare the Supraglottic Airway device I-Gel with Classic LMA and Proseal LMA for airway management in anaesthetised spontaneously ventilating patients. MATERIALS AND METHODS 120 patients of ASA I and II scheduled for routine short surgical procedure (lasting upto 1 hour) were randomly selected. Patients were divided into three Groups I, C, P. (40 in each group). All patients pre-medicated with Inj. Glycopyrrolate 0.004 mg/kg, Inj. Midazolam 0.02 mg/kg, Inj. Ranitidine 1 mg/kg and Inj. Metoclopramide 0.1 mg/kg. Patients were induced with Inj. fentanyl 2 mcg/kg and Inj. propofol 2 mg/kg. A proper size Supraglottic Airway Classic LMA (Group C), Proseal LMA (Group P) and I-Gel (Group I) was inserted. Maintenance was done with Oxygen, Nitrous Oxide and Isoflurane. Time of insertion of device, number of attempts for insertion, any complications, haemodynamic parameters (HR, MAP, SpO2, ETCO2) and airway leak pressure were noted. After completion of the procedure, the Supraglottic Airway was removed. RESULTS Meantime for insertion in I Group (12.13 + 1.48) sec is less compared to Group C (16.25 + 1.032) and Group P (19.48 + 1.710). The difference was statistically significant with P value < 0.001. The mean numbers of attempt in three groups are similar. The success rate of insertion in the first attempt is not statistically significant. HR and MAP did not show any difference in the three groups. Group I and Group P have significant higher value of leak pressure compared to Group C and statistically significant. Higher incidence of post-operative sore throat was observed in Group C. CONCLUSION I-Gel, the new supraglottic device is easier to insert with short time and high success rate of insertion in first attempt. I-Gel has a slightly higher leak pressure compared to classic LMA with no incidence of post-operative sore throat. I-Gel is the better alternative to other supraglottic device.