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Priya H, Sripriya R, Ravishankar M, Karthikeyan P, Charulatha R. Baska Mask is non-inferior to tracheal tube in preventing airway contamination during controlled ventilation in elective nasal surgeries: A randomised controlled trial. Indian J Anaesth 2021; 65:586-592. [PMID: 34584281 PMCID: PMC8445220 DOI: 10.4103/ija.ija_237_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/26/2021] [Accepted: 08/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background and Aims: Baska Mask, a newly designed third-generation supraglottic device, has a sump where the pharyngeal secretions can collect and be suctioned out continuously. We aimed to study the effectiveness of Baska Mask in preventing airway contamination during nasal surgeries. Our primary objective was to assess airway soiling using fibreoptic bronchoscopy. Total airway manipulation time, haemodynamic parameters during device insertion and post-operative oro-pharyngeal morbidities were the secondary objectives. Methods: Eighty-four participants undergoing nasal surgeries were randomised to either have their airway maintained with Baska Mask (Group-BM) or Endotracheal tube (Group-TT). Fibreoptic bronchoscopy was performed at the end of the surgery and the airway was inspected for signs of contamination. Total airway manipulation time, haemodynamic parameters during device insertion and post-operative oro-pharyngeal morbidities were also assessed. Unpaired Student's t test was used for parametric data and Chi-square test for nonparametric data. One-way analysis of variance (ANOVA) was used for the intra-group analysis of haemodynamic data. Results: Tracheal contamination was not observed in any patient in either group. Time taken for device insertion (Group TT: 24.24 ± 6.86 s vs. Group BM: 24.22 ± 7.3 s; P = 0.97) was similar in both the groups. The total airway manipulation time was 2 min longer in Group-TT (P = 0.000) due to additional time taken for insertion of throat pack. Haemodynamic parameters during device insertion were stable and post-operative oro-pharyngeal morbidities were fewer with Baska Mask when compared to Tracheal tube. Conclusions: Baska Mask is non-inferior to tracheal tube in preventing tracheal contamination in patients undergoing nasal surgeries.
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Affiliation(s)
- H Priya
- Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
| | - R Sripriya
- Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
| | - M Ravishankar
- Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
| | - P Karthikeyan
- Department of Otorhinolaryngology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
| | - R Charulatha
- Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
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Tosh P, Kumar RB, Sahay N, Suman S, Bhadani UK. Efficacy of Baska mask as an alternative airway device to endotracheal tube in patients undergoing laparoscopic surgeries under controlled ventilation. J Anaesthesiol Clin Pharmacol 2021; 37:419-424. [PMID: 34759555 PMCID: PMC8562437 DOI: 10.4103/joacp.joacp_339_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/18/2020] [Accepted: 06/14/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND AND AIMS Newer supraglottic devices with an additional gastric channel offer greater protection from aspiration and avoidance of laryngoscopy for their insertion would result in attenuated hemodynamic responses.The primary objective was to assess hemodynamic responses to insertion of Baska mask as compared to tracheal intubation. The time and attempts taken to secure airway and evidence of regurgitation and pulmonary aspiration of gastric contents were also assessed. MATERIAL AND METHODS This prospective, randomized study was conducted in 80 patients undergoing laparoscopic cholecystectomy. All patients received standardized anaesthesia protocol. Baska mask was used to secure airway in Group B, while tracheal intubation was done in group T. Methylene blue was injected through Ryle's tube into stomach in both groups. At end of surgery, fibreoptic bronchoscopy was performed to detect bluish staining of trachea and/or main bronchi as evidence of aspiration of gastric contents and bluish staining in oropharynx as evidence of regurgitation. Chi-square test and Independent sample t-test were applied. RESULTS The time taken to secure airway was significantly longer in Group B as compared to Group T (45.3 ± 12.6 vs. 24.3 ± 9.1 sec) Percentage of patients who had oropharyngeal blue stain was comparable in both groups. No patient in both groups had tracheal blue stain. Group T had significantly higher HR and MAP after intubation till 10 min later. CONCLUSION Baska mask insertion was associated with attenuated hemodynamic responses, though more time and attempts were required for securing the airway. It could be considered as an alternative to tracheal intubation during laparoscopic surgeries.
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Affiliation(s)
- Pulak Tosh
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Patna, India
| | - Ravi B. Kumar
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Patna, India
| | - Nishant Sahay
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Patna, India
| | - Saurabh Suman
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Patna, India
| | - Umesh K. Bhadani
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Patna, India
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Sidhu GK, Jindal S, Mahajan R, Bhagat S. Influence of head and neck positions on oropharyngeal seal pressure with Baska mask ® versus I-gel™; A randomised clinical study. Indian J Anaesth 2020; 64:675-680. [PMID: 32934401 PMCID: PMC7457996 DOI: 10.4103/ija.ija_185_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/03/2020] [Accepted: 06/03/2020] [Indexed: 11/09/2022] Open
Abstract
Background and Aims: Oropharyngeal seal pressure (OSP) achieved by a supraglottic airway device holds due importance as it indicates the feasibility of positive pressure ventilation, the degree of airway protection from supra-cuff soiling and also relates to postoperative morbidity. The primary outcome measure was to assess and compare OSP in different head and neck positions with Baska mask® and I-gel™. Secondary outcome measures were to compare peak inspiratory pressure (PIP), exhaled tidal volume (ETV), ease of insertion, time taken for insertion, number of attempts, intraoperative manipulations, and postoperative airway morbidity with both the devices. Materials and Methods: Seventy consenting adults scheduled for a variety of surgical procedures under general anesthesia were allocated to Group B and Group G using Baska mask® and I-gel™ respectively. All statistical calculations were done using SPSS (Statistical Package for the Social Science). The comparison of quantitative variables between the study groups was done using Student t-test and within the variables was done by paired t-test. For comparing categorical data, Chi-square (χ2) test was performed. Results: OSP was significantly higher in group B than in group G in all head and neck positions (neutral 33 ± 2.8 vs. 23.2 ± 1.8, flexion 35.5 ± 2.5 vs. 25.2 ± 1.6, extension 30.6 ± 2.7 vs. 21.4 ± 1.7, right lateral 32.6 ± 2.8 vs. 23.0 ± 1.5. left lateral 32.6 ± 2.7 vs. 23.1 ± 1.7 cm H2O, respectively) (P = 0.000). PIP increased significantly in group G as compared to group B in flexion. (P = 0.009). Baska mask® had significantly higher ETV in flexion compared to I-gel™. (P = 0.009). Conclusion: Baska mask® may provide a useful alternative to I-gel™ where the glottic seal has precedence over ease of insertion.
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Affiliation(s)
- Gurkaran Kaur Sidhu
- Department of Anaesthesia and Intensive Care, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Seema Jindal
- Department of Anaesthesia and Intensive Care, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Rupali Mahajan
- Department of Anaesthesia and Intensive Care, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Sheetal Bhagat
- Department of Anaesthesia and Intensive Care, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
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Kapoor D, Singh J, Mitra S, Viswanath O, Kaye AD, Urits I, Orhurhu V. Gnana Laryngeal Airway in Clinical Practice: A Prospective Observational Study. Turk J Anaesthesiol Reanim 2019; 48:280-287. [PMID: 32864642 PMCID: PMC7434353 DOI: 10.5152/tjar.2019.00243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 08/15/2019] [Indexed: 11/22/2022] Open
Abstract
Objective The Gnana Laryngeal Airway (GLA) device, a novel supraglottic airway device, is similar to the LMA-Classic in basic design, but with an additional suction port on the convex portion of the laryngeal mask to remove the saliva. We evaluated the GLA device in terms of ease and time to insertion, the number of attempts, oropharyngeal leak pressure (OLP), correct placement, and complications in adult patients undergoing elective surgical procedures. Methods After general anaesthesia, the GLA device was inserted in ASA Class I–II consecutive patients aged 18–60 years, who were scheduled for elective surgeries lasting <2h. An independent observer noted (1) 10 consecutive successful GLA device insertions, all on the first attempt; (2) 10 consecutive device insertions, each <20 second in duration; and (3) 10 consecutive patients with the mean leak <10%. The criteria were fulfilled in 50 consecutive patients. Results In 72% of patients, the GLA device was successfully placed on the first attempt and was effortless in 64%. Between the first 10 and last 10 consecutive patients of the total 50, the ease-of-insertion grade progressively decreased (mean±standard deviation [SD]: 2.80±0.25 to 1.30±0.15, p<0.0001) and so did insertion time in seconds (28.70±1.87 to 14.20±0.79, p<0.0001). The post-insertion, OLP and airway compliance progressively increased, while the cuff inflation volume, peak airway pressure and airway resistance progressively decreased, along with minimal side effects and malposition. Conclusion The GLA device insertion became progressively easier and faster; thus, such a device is promising and warrants further clinical evaluation.
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Affiliation(s)
- Dheeraj Kapoor
- Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India
| | - Jasveer Singh
- Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India
| | - Sukanya Mitra
- Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India
| | - Omar Viswanath
- Valley Anaesthesiology and Pain Consultants, Phoenix, AZ; Creighton University School of Medicine - Phoenix Regional Campus, Phoenix, AZ; University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ, USA
| | - Alan David Kaye
- Department of Anaesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University School of Medicine, Shreveport, Louisiana, USA
| | - Ivan Urits
- Beth Israel Deaconess Medical Center, Department of Anaesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA
| | - Vwaire Orhurhu
- Beth Israel Deaconess Medical Center, Department of Anaesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA
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Garg A, Lamba NS, Ajai Chandra NS, Singhal RK, Chaudhary V. Supraglottic airway devices in short gynecological procedures: A randomized, clinical study comparing the Baska ® mask and I-Gel ® device. J Family Med Prim Care 2019; 8:1134-1137. [PMID: 31041263 PMCID: PMC6482730 DOI: 10.4103/jfmpc.jfmpc_359_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Supraglottic airway devices are used for anesthesia in elective surgical procedures circumventing the need for intubation. We investigated the efficacy and safety of Baska® mask in comparison to an I-Gel® device. Methods In this cross-sectional, observational study, we randomized 100 female patients (age 18-45 years, American Society of Anaesthesiologists grade I or II) undergoing elective short gynecological procedures into two groups, to receive ventilation with either Baska mask® (group 1, n = 50) or an I-Gel® device (group 2, n = 50). We excluded patients with obesity, short neck, and known systemic and upper airway disorders. The primary outcome was the oropharyngeal airway seal pressure, and the secondary outcomes were the ease of insertion and the complication rate. The results were analyzed using Mann-Whitney U-test and Fisher's exact test, and correlation analysis was done by Spearman's correlation test. Results A total of 56 patients underwent dilatation and curettage, whereas the remaining had hysteroscopy in the study. The airway seal pressure achieved was higher with Baska® mask than I-Gel® device (35.8 ± 10.3 and 26.9 ± 7.5 of cm H2O, respectively; P < 0.0001). The ease of insertion (P < 0.0001) was better in group 1 and the complication rates were similar in both the groups (P > 0.05). Conclusion Baska® mask offers a superior airway seal pressure with minimum complications in comparison to an I-Gel® device. Further studies with a large number of patients in different surgical settings are required to confirm our findings.
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Affiliation(s)
- Anurag Garg
- Department of Anesthesiology and Critical Care, Command Hospital, Chandimandir, Panchkula, Haryana, India
| | - N S Lamba
- Department of Anesthesiology and Critical Care, Command Hospital, Chandimandir, Panchkula, Haryana, India
| | - N S Ajai Chandra
- Department of Anesthesiology and Critical Care, Command Hospital, Chandimandir, Panchkula, Haryana, India
| | - R K Singhal
- Department of Anesthesiology and Critical Care, Command Hospital, Chandimandir, Panchkula, Haryana, India
| | - Vishal Chaudhary
- Department of Anesthesiology and Critical Care, Command Hospital, Chandimandir, Panchkula, Haryana, India
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Parikh DA, Jain RA, Lele SS, Tendolkar BA. A cohort evaluation of clinical use and performance characteristics of Ambu ® AuraGain™: A prospective observational study. Indian J Anaesth 2017; 61:636-642. [PMID: 28890558 PMCID: PMC5579853 DOI: 10.4103/ija.ija_285_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND AND AIMS Ambu® AuraGain™ (AG) (Ambu, Ballerup, Denmark) is a supraglottic device which has a design facilitating its use as a conduit for intubation. We designed this prospective observational study to assess the ease of AG placement in paralysed patients, determine its position and alignment to the glottis and assess its utility as a conduit for intubation. METHODS One hundred patients, aged 18-60 years, American Society of Anesthesiologists physical status I-II, undergoing elective surgery under general anaesthesia were included in the study. The ease and number of attempts for successful insertion, ease of gastric tube insertion, leak pressures, fibre-optic grade of view, number of attempts and time for tracheal intubation, time for AG removal and complications were recorded. The mean, standard deviation (SD), interquartile range (IQR) and range were calculated. The upper limit of confidence interval for overall failure rate was calculated using Wilson's score method. RESULTS AG was successfully inserted in all patients. The mean (SD) time taken for insertion was 17.32 (8.48) s. The median [IQR] leak pressures were 24 [20-28] cm of H2O. Optimal laryngeal view for intubation was obtained in 68 patients. Eighty-eight patients could be intubated in the first attempt. Five patients could not be intubated. The overall failure rate of device was 9%. CONCLUSION AMBU® AuraGain™ serves as an effective ventilating aid, but caution is suggested before using it as a conduit for endotracheal intubation.
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Affiliation(s)
- Devangi A Parikh
- Department of Anaesthesiology, Lokmanya Tilak Municipal General Hospital, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Ruchi A Jain
- Department of Anaesthesiology, Lokmanya Tilak Municipal General Hospital, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Smita S Lele
- Department of Anaesthesiology, Lokmanya Tilak Municipal General Hospital, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Bharati A Tendolkar
- Department of Anaesthesiology, Lokmanya Tilak Municipal General Hospital, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
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Carrió Font M, García-Aguado R, Úbeda Pascual J. Laparoscopic Nissen fundoplication with Baska Mask ® laryngeal mask. ACTA ACUST UNITED AC 2016; 63:599-603. [PMID: 27208897 DOI: 10.1016/j.redar.2016.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 03/30/2016] [Accepted: 03/31/2016] [Indexed: 11/29/2022]
Abstract
Tracheal intubation has historically been considered the ideal technique to handle the airway in laparoscopic surgical procedures. The introduction of such procedures in ambulatory surgery requires the use of anesthetic techniques that offer optimal and early postoperative recovery under strict security conditions. Laryngeal mask is proposed as a suitable alternative to tracheal intubation, even in high risk patients due to new devices which have been modified to improve their characteristics, becoming great alternatives in the overall management of the airway. We report the first case of laparoscopic Nissen fundoplication performed with a laryngeal Baska Mask in patient with high risk of regurgitation due to its gastroesophageal reflux.
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Affiliation(s)
- M Carrió Font
- Servicio de Anestesia, Hospital Clínico Universitario San Juan de Alicante, Alicante, España.
| | - R García-Aguado
- Servicio Anestesia, Reanimación y Unidad del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - J Úbeda Pascual
- Servicio Anestesia, Reanimación y Unidad del Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, España
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