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Chaki T, Koizumi M, Tachibana S, Matsumoto T, Kumagai T, Hashimoto Y, Yamakage M. Comparing leak pressure of LMA ® ProSeal™ versus i-gel ® at head rotation: a randomized controlled trial. Can J Anaesth 2024; 71:66-76. [PMID: 38017196 DOI: 10.1007/s12630-023-02648-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/12/2023] [Accepted: 07/12/2023] [Indexed: 11/30/2023] Open
Abstract
PURPOSE The effect of head rotation on supraglottic airway (SGA) oropharyngeal leak pressure (OPLP) has not been well elucidated. The aim of this study was to help clarify which SGA device provides higher OPLP at head-rotated position. METHODS Patients who underwent elective surgery under general anesthesia were enrolled and randomly divided into laryngeal mask airway (LMA®) ProSeal™ and i-gel® groups. The allocated SGA device was inserted under anesthesia. The primary outcome was OPLP, and secondary outcomes were ventilation score, expiratory tidal volume, and maximum pressure under volume-controlled ventilation (VCV) with an inspiratory tidal volume of 10 mL·kg-1 ideal body weight and fibreoptic view of the vocal cords at 0°, 30°, and 60° head rotation. RESULTS Data from 78 and 76 patients were analyzed in the LMA ProSeal and i-gel groups, respectively. The mean (standard deviation) OPLP of the LMA ProSeal was significantly higher than that of the i-gel at the 60° head-rotated position (LMA ProSeal, 20.4 [6.5] vs i-gel, 16.9 [7.8] cm H2O; difference in means, 3.6; adjusted 95% confidence interval, 0.5 to 6.6; adjusted P = 0.02, adjusted for six comparisons). The maximum pressure under VCV at 60° head rotation was significantly higher in the LMA ProSeal group than in the i-gel group. The expiratory tidal volume of the LMA ProSeal did not significantly change with head rotation and was significantly higher than that of the i-gel at 60° head rotation. Ventilation score, fibreoptic view of the vocal cords, and complications were not significantly different between the ProSeal and i-gel groups. CONCLUSIONS The LMA ProSeal provides higher OPLP than the i-gel at a 60° head-rotated position under general anesthesia. TRIAL REGISTRATION Japan Registry of Clinical Trials (https://jrct.niph.go.jp) (JRCT1012210043); registered 18 October 2021.
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Affiliation(s)
- Tomohiro Chaki
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Masatsugu Koizumi
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shunsuke Tachibana
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tomomi Matsumoto
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tomoe Kumagai
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yuki Hashimoto
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Michiaki Yamakage
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Güth J, Jung P, Schiele A, Urban B, Parsch A, Matsche B, Eich C, Becke-Jakob K, Landsleitner B, Russo SG, Bernhard M, Hossfeld B, Olivieri M, Hoffmann F. [Update 2022: interdisciplinary statement on airway management with supraglottic airway devices in pediatric emergency medicine-The laryngeal mask is and remains state of the art : Joint statement of the Institute for Emergency Medicine and Medicine Management (INM), the University Clinic Munich, LMU Munich, Germany, the Working Group for Pediatric Critical Care and Emergency Medicine of the German Interdisciplinary Society for Critical Care and Emergency Medicine (DIVI), the Medical Directors of Emergency Medical Services in Bavaria (ÄLRD), the Scientific Working Group for Pediatric Anesthesia (WAKKA) of the German Society for Anesthesiology and Intensive Care Medicine (DGAI), the Scientific Working Group for Emergency Medicine of the German Society for Anesthesiology and Intensive Care Medicine (DGAI) and the Society of Neonatology and Pediatric Critical Care Medicine (GNPI)]. DIE ANAESTHESIOLOGIE 2023:10.1007/s00101-023-01284-2. [PMID: 37222766 DOI: 10.1007/s00101-023-01284-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Airway management with supraglottic airway devices (SGA) in life-threatening emergencies in children is increasingly being used. Different specifications of laryngeal masks (LM) and the laryngeal tube (LT) are commonly used devices for this purpose. We present a literature review and interdisciplinary consensus statement of different societies on the use of SGA in pediatric emergency medicine. MATERIAL AND METHODS Literature review in the PubMed database and classification of studies according to the criteria of the Oxford Centre for Evidence-based Medicine. Levels and consensus finding within the group of authors. RESULTS The evidence for successful applications of the various types of LM is significantly higher than for LT application. Reported smaller series of successful applications of LT are currently limited to selected research groups and centers. Especially for children below 10 kg body weight there currently exists insufficient evidence for the successful application of the LT and therefore its routine use cannot be recommended. SGAs used for emergencies should have a gastric drainage possibility. DISCUSSION Considering the scientific data and the large clinical experience with the LM in medical routine and emergency situations in children currently only the LM can be recommended for alternative (i.e., non-intubation) emergency airway management in children. If alternative airway management is part of a local emergency strategy, the LM should be provided in all pediatric sizes (1, 1½, 2, 2½, 3) for out of hospital use and in hospital emergency use and all users should regularly be trained in its application.
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Affiliation(s)
- J Güth
- Institut für Notfallmedizin und Medizinmanagement (INM), Klinikum der Universität München, München, Deutschland
| | - P Jung
- Sektion Pädiatrische Intensiv- und Notfallmedizin, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
| | - A Schiele
- Ärztliche Leitung, Rettungsdienst Bayern (ÄLRD Bayern), München, Deutschland
| | - B Urban
- Institut für Notfallmedizin und Medizinmanagement (INM), Klinikum der Universität München, München, Deutschland
| | - A Parsch
- Ärztliche Leitung, Rettungsdienst Bayern (ÄLRD Bayern), München, Deutschland
| | - B Matsche
- Ärztliche Leitung, Rettungsdienst Bayern (ÄLRD Bayern), München, Deutschland
| | - C Eich
- Sektion Pädiatrische Intensiv- und Notfallmedizin, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA), Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - K Becke-Jakob
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA), Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - B Landsleitner
- Sektion Pädiatrische Intensiv- und Notfallmedizin, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA), Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - S G Russo
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA), Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - M Bernhard
- Wissenschaftlicher Arbeitskreis Notfallmedizin, Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - B Hossfeld
- Sektion Pädiatrische Intensiv- und Notfallmedizin, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
| | - M Olivieri
- Sektion Pädiatrische Intensiv- und Notfallmedizin, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
| | - F Hoffmann
- Sektion Pädiatrische Intensiv- und Notfallmedizin, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland.
- Gesellschaft für Neonatologie und Pädiatrische Intensivmedizin (GNPI), Berlin, Deutschland.
- Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Institut für Notfallmedizin und Medizinmanagement (INM), Ludwig-Maximilians-Universität München, Lindwurmstr. 4, 80337, München, Deutschland.
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Wang B, Du L, Zhang L, Zheng J. Prewarming non-inflatable cuff laryngeal mask for mechanical ventilation: A systematic review and meta-analysis with trial sequential analysis. Medicine (Baltimore) 2022; 101:e31032. [PMID: 36316864 PMCID: PMC9622593 DOI: 10.1097/md.0000000000031032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Non-inflatable cuff laryngeal masks are generally composed of thermoplastic material. The thermoplastic nature of the non-inflatable cuff will become soft and match the laryngeal anatomy better as it reaches body temperature after intubation. This meta-analysis aims to evaluate the clinical validity of prewarming non-inflatable cuff laryngeal mask before insertion. METHODS We searched PubMed, Cochrane Library, Embase, Web of Science, Ovid Medline, CNKI, Wan Fang Database and VIP Database to find randomized controlled trials (RCTs) researching the clinical validity of prewarming non-inflatable cuff laryngeal mask. The retrieval time is up to June 2022. Articles published in the English and Chinese languages were considered. Quality assessment was conducted with the Cochrane Collaboration's tool and GRADE (Grading of Recommendations Assessment, Development and Evaluation) method. Subgroup analyses and trial sequential analysis (TSA) were performed to control the risk of random errors. Publication bias was assessed by funnel plots and Egger's regression test. The outcomes included sealing pressure immediately after successful ventilation, the first-attempt intubation success rate and the incidence of postoperative pharyngeal pain. RESULTS Eight RCTs evaluating 683 patients were identified. Pooled results showed that compared to the control group, prewarming non-inflatable cuff laryngeal mask provided a higher sealing pressure immediately after successful ventilation (mean difference: 1.73 cm H2O; 95% confidence interval [CI]: 0.95-2.52; P < .0001; I2 = 16; high quality), higher first-attempt intubation success rate (risk ratio [RR]: 1.05; 95% CI: 1.01-1.09; P = .01; I2 = 26%; high quality, number needed to treat [NNT] = 22 [95% CI 12.5-100]) and lower incidence of postoperative pharyngeal pain (RR: 0.59, 95% CI: 0.46-0.75; P < .0001; I2 = 0; high quality, NNT = 6 [95% CI 4.17-9.09]). The results were confirmed by TSA. CONCLUSION Prewarming non-inflatable cuff laryngeal mask could provide better mechanical ventilation efficiency with higher sealing pressure, a higher first-attempt intubation success rate and a lower incidence of postoperative pharyngeal pain. TRIAL REGISTRATION NUMBER PROSPERO CRD42021245350.
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Affiliation(s)
- Bo Wang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Du
- Department of Anesthesiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Lu Zhang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jianqiao Zheng
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- *Correspondence: Jianqiao Zheng, Department of Anesthesiology, West China Hospital, Sichuan University, No.37, Guo Xue Alley, Chengdu 610041, Sichuan, China (e-mail: )
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Klementova O, Bhoday TK, Werner J, Lopez AM, Donaldson W, Lichnovsky E, Gaszyński T, Henlin T, Bruthans J, Ulrichova J, Lukes M, Blaha J, Kral M, Gomez L, Berge R, Holland J, McAleavey F, Arava S, Merjava Skripecka L, Sobczyk S, Tyll T, Michalek P. Evaluation of the insertion parameters and complications of the i-gel Plus airway device for maintaining patent airway during planned procedures under general anaesthesia: a protocol for a prospective multicentre cohort study. BMJ Open 2021; 11:e053215. [PMID: 34930740 PMCID: PMC8689171 DOI: 10.1136/bmjopen-2021-053215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Supraglottic airway devices represent a less invasive method of airway management than tracheal intubation during general anaesthesia. Their continued development is focused mainly on improvements in the insertion success rate and minimalisation of perioperative and postoperative complications. The i-gel Plus is a novel, anatomically preshaped supraglottic airway device which achieves a perilaryngeal seal due to a non-inflatable cuff made of a soft thermoplastic elastomer. The purpose of this cohort study is to assess the success rate of the i-gel Plus use during elective procedures under general anaesthesia, its intraoperative performance, and the degree of postoperative complications. METHODS AND ANALYSIS This is a multicentre, prospective, interventional cohort study. The enrolment will take place in seven centres in four European countries. We plan to enrol 2000 adult patients in total, who are scheduled for elective surgery under general anaesthesia, and with an indication for use of a supraglottic airway device for management of their airway. The study is projected to run over a period of 18 months. The primary outcome of the study is the total success rate of the i-gel Plus insertion in terms of successful ventilation and oxygenation through the device. Secondary outcomes include perioperative parameters, such as insertion time, seal/leak pressures, number of insertion attempts and postoperative adverse events and complications. Postoperative follow-up will be performed at 1 hour, 24 hours in all patients, and for selected patients at 3 and 6 months. ETHICS AND DISSEMINATION The cohort study has received the following ethical approvals: General University Hospital Prague, University Hospital Olomouc, University Military Hospital Prague, University Hospital Barcelona, University Hospital Lodz, Antrim Area Hospital, Craigavon Area Hospital, Office for Research Ethics Committees Northern Ireland. The results will be published in peer-reviewed journals and presented at relevant anaesthesia conferences. TRIAL REGISTRATION NUMBER ISRCTN86233693;Pre-results.
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Affiliation(s)
- Olga Klementova
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Olomouc, Olomouc, Czech Republic
| | - Taranpreet Kaur Bhoday
- Department of Anesthesiology and Intensive Medicine, General University Hospital in Prague, Praha, Czech Republic
| | - Jakub Werner
- Department of Anesthesiology and Intensive Medicine, General University Hospital in Prague, Praha, Czech Republic
| | - Ana M Lopez
- Department of Anesthesia, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Will Donaldson
- Department of Anaesthesia, Antrim Area Hospital, Antrim, UK
| | - Erik Lichnovsky
- Department of Anaesthesia, Craigavon Area Hospital, Portadown, UK
| | - Tomasz Gaszyński
- Department of Anaesthesiology and Intensive Therapy, Medical University of Lodz, Lodz, Poland
| | - Tomas Henlin
- Department of Anesthesia and Intensive Medicine, Military University Hospital Prague, Praha, Czech Republic
| | - Jan Bruthans
- Department of Anesthesiology and Intensive Medicine, General University Hospital in Prague, Praha, Czech Republic
| | - Jitka Ulrichova
- Department of Anesthesiology and Intensive Medicine, General University Hospital in Prague, Praha, Czech Republic
| | - Martin Lukes
- Department of Anesthesiology and Intensive Medicine, General University Hospital in Prague, Praha, Czech Republic
| | - Jan Blaha
- Department of Anesthesiology and Intensive Medicine, General University Hospital in Prague, Praha, Czech Republic
| | - Michal Kral
- Department of Anesthesiology and Intensive Medicine, University Hospital Olomouc, Olomouc, Czech Republic
| | - Lidia Gomez
- Department of Anesthesia, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Raquel Berge
- Department of Anesthesia, Hospital Clinic de Barcelona, Barcelona, Spain
| | | | | | - Shiva Arava
- Department of Anaesthesia, Craigavon Area Hospital, Portadown, UK
| | | | - Sebastian Sobczyk
- Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, Lodz, Poland
| | - Tomas Tyll
- Department of Anesthesia and Intensive Medicine, Military University Hospital Prague, Praha, Czech Republic
| | - Pavel Michalek
- Anaesthesia and Intensive Medicine, General University Hospital in Prague, Praha, Czech Republic
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Zheng J, Du L, Wang J, Zhang L, Chen G. Prewarming i-gel laryngeal mask for mechanical ventilation: a meta-analysis of randomised control trials and trial sequential analysis. BMJ Open 2021; 11:e045461. [PMID: 34376440 PMCID: PMC8356164 DOI: 10.1136/bmjopen-2020-045461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To systematically evaluate the efficiency of prewarming i-gel laryngeal mask for mechanical ventilation by meta-analysis and trial sequential analysis. DESIGN Systematic review and meta-analysis. DATA SOURCES Cochrane library, Web of Science, Ovid Medline and PubMed were searched from their inception to 31 August 2020. Only articles published in English language were considered. METHODS Randomised controlled trials (RCTs) comparing the efficiency of prewarming i-gel laryngeal mask versus keeping it at room temperature for mechanical ventilation were included. Primary outcome was sealing pressure immediately after successful ventilation. Secondary outcomes were the first-attempt insertion success rate and the incidence of postoperative pharyngeal pain. Two authors independently selected studies. Quality analysis was performed using the modified Jadad Scale. Trial sequential analysis (TSA) was used to control risk of random errors. Sensitivity analysis was done to assess the effect of a single study on the pooled estimates. Publication bias was assessed by funnel plots and Egger's regression test. RESULTS Four RCTs comprising 374 patients were included. The results of meta-analysis showed that compared with the control group, prewarming i-gel laryngeal mask provides a higher sealing pressure immediately after successful ventilation (mean difference 2.19 cm H2O; 95% CI (1.17 to 3.21); p<0.0001; high quality), with firm evidence from TSA and lower publication bias (p=0.7372). No significant difference was observed in the first-attempt insertion success rate (relative ratio (RR) 1.06; 95% CI (1.00 to 1.12); p=0.07; high quality) with lower publication bias (p=0.1378). The TSA indicating further trials are required. No significant difference was assessed in the incidence of postoperative pharyngeal pain (RR 1.0; 95% CI (0.14 to 6.90); p=1.0; high quality). CONCLUSION Prewarming i-gel laryngeal mask provides higher sealing pressure compared with keeping it at room temperature. But prewarming i-gel laryngeal mask did not increase the first-attempt insertion success rate, nor did it decrease the incidence of postoperative pharyngeal pain.
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Affiliation(s)
- Jianqiao Zheng
- Department of Anesthesiology, Sichuan University West China Hospital, Chengdu, China
| | - Li Du
- Department of Anesthesiology, Sichuan Cancer Hospital and Research Institute, Chengdu, China
| | - Jia Wang
- Department of Anesthesiology, Sichuan University West China Hospital, Chengdu, China
| | - Lu Zhang
- Department of Anesthesiology, Sichuan University West China Hospital, Chengdu, China
| | - Guo Chen
- Department of Anesthesiology, Sichuan University West China Hospital, Chengdu, China
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Chaki T, Tachibana S, Kumita S, Sato H, Hamada K, Tokinaga Y, Yamakage M. Head Rotation Reduces Oropharyngeal Leak Pressure of the i-gel and LMA® Supreme™ in Paralyzed, Anesthetized Patients: A Randomized Trial. Anesth Analg 2021; 132:818-826. [PMID: 32889846 DOI: 10.1213/ane.0000000000005150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Second-generation supraglottic airway (SGA) devices are useful for airway management during positive pressure ventilation in general anesthesia and emergency medicine. In some clinical settings, such as the anesthetic management of awake craniotomy, SGAs are used in the head-rotated position, which is required for exposure of the surgical field, although this position sometimes worsens the efficiency of mechanical ventilation with SGAs. In this study, we investigated and compared the influence of head rotation on oropharyngeal leak pressures (OPLP) of the i-gel and LMA® Supreme™, which are second-generation SGA devices. METHODS Patients who underwent elective surgery under general anesthesia were enrolled in this study and randomly divided into i-gel or LMA Supreme groups. After induction of anesthesia with muscle relaxation, the i-gel or LMA Supreme was inserted according to computerized randomization. The primary outcome was the OPLP at 0°, 30°, and 60° head rotation. The secondary outcomes were the maximum airway pressure and expiratory tidal volume when patients were mechanically ventilated using a volume-controlled ventilation mode with a tidal volume of 10 mL/kg (ideal body weight), ventilation score, and fiber-optic views of vocal cords. RESULTS Thirty-four and 36 participants were included in the i-gel and LMA Supreme groups, respectively. The OPLPs of the i-gel and LMA Supreme significantly decreased as the head rotation angle increased (mean difference [95% confidence interval], P value: i-gel; 0° vs 30°: 3.5 [2.2-4.8], P < .001; 30° vs 60°: 2.0 [0.6-3.5], P = .002; 0° vs 60°: 5.5 [3.3-7.8], P < .001, LMA Supreme; 0° vs 30°: 4.1 [2.6-5.5], P < .001; 30° vs 60°: 2.4 [1.1-3.7], P < .001; 0° vs 60°: 6.5 [5.1-8.0], P < .001). There were statistically significant differences in expiratory tidal volume and ventilation score between 0° and 60° in the i-gel group and in ventilation score between 30° and 60° in the LMA Supreme group. There was no statistically significant difference between the 2 devices in all outcome measures. The incidences of adverse events, such as hoarseness or sore throat, were not significantly different between i-gel and LMA Supreme. CONCLUSIONS Head rotation to 30° and 60° reduces OPLP with both i-gel and LMA Supreme. There is no difference in OPLP between i-gel and LMA Supreme in the 3 head rotation positions.
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Affiliation(s)
- Tomohiro Chaki
- From the Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shunsuke Tachibana
- From the Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan.,Department of Anesthesiology, Takikawa Municipal Hospital, Takikawa, Japan
| | - Sho Kumita
- From the Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Honami Sato
- From the Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kosuke Hamada
- From the Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yasuyuki Tokinaga
- From the Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Michiaki Yamakage
- From the Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Chelikani V, Bhardwaj P, Kumar L, On SLW, Mohan MS, Olivero A, Thake L, Ramadhani S, Wescombe PA, Olejar KJ. Novel viscoelastic gelling agent with unique physico-chemical properties. Food Chem 2020; 344:128715. [PMID: 33277129 DOI: 10.1016/j.foodchem.2020.128715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/19/2020] [Accepted: 11/19/2020] [Indexed: 10/22/2022]
Abstract
A novel innovative viscoelastic gelling agent (novel gel, NG) has been developed by combining citric acid (CA) and disodium 5-guanylate (DG). NG has the potential to replace other gelling agents such as gelatine, which has been commonly used in foods, dietary supplements, pharmaceutical and cosmetic products including ointments and sprays. NG has unique physico-chemical properties, including a wide range of concentration-dependent, temperature-sensitive gel strengths. Based on the rheological measurement results, NG depicted similar shear thinning behaviour to gelatine, within shear rates ranging from 25.8 to 129 (s-1). NG also significantly increased the shelf-life (by 21 days) of minced beef, as well as inhibited the growth of major spoilage pathogens, such as E. coli, S. aureus, Salmonella sp., Listeria sp., yeast and moulds, making it an ideal candidate for gelatine replacement.
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Affiliation(s)
- Venkata Chelikani
- Faculty of Agriculture and Life Sciences, Lincoln University, PO Box 84, Lincoln 7647, Canterbury, New Zealand.
| | - Piyush Bhardwaj
- Faculty of Agriculture and Life Sciences, Lincoln University, PO Box 84, Lincoln 7647, Canterbury, New Zealand
| | - Lokesh Kumar
- Faculty of Agriculture and Life Sciences, Lincoln University, PO Box 84, Lincoln 7647, Canterbury, New Zealand
| | - Stephen L W On
- Faculty of Agriculture and Life Sciences, Lincoln University, PO Box 84, Lincoln 7647, Canterbury, New Zealand
| | - Maneesha S Mohan
- Faculty of Agriculture and Life Sciences, Lincoln University, PO Box 84, Lincoln 7647, Canterbury, New Zealand
| | - Avitta Olivero
- Faculty of Agriculture and Life Sciences, Lincoln University, PO Box 84, Lincoln 7647, Canterbury, New Zealand
| | - Loane Thake
- Faculty of Agriculture and Life Sciences, Lincoln University, PO Box 84, Lincoln 7647, Canterbury, New Zealand
| | - Sintia Ramadhani
- Faculty of Agriculture and Life Sciences, Lincoln University, PO Box 84, Lincoln 7647, Canterbury, New Zealand
| | - Philip A Wescombe
- Yili Innovation Centre Oceania, Lincoln University, PO Box 84, Lincoln 7647, Canterbury, New Zealand
| | - Kenneth J Olejar
- Faculty of Agriculture and Life Sciences, Lincoln University, PO Box 84, Lincoln 7647, Canterbury, New Zealand
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Wang L, Xia H, Han P, Cao R, Xu T, Li W, Zhang H, Zhang S. Synthesis of new PPG and study of heterogeneous combination flooding systems. J DISPER SCI TECHNOL 2020. [DOI: 10.1080/01932691.2020.1845719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Lihui Wang
- School of Petroleum Engineering, Northeast Petroleum University, Heilongjiang, Daqing, China
| | - Huifen Xia
- School of Petroleum Engineering, Northeast Petroleum University, Heilongjiang, Daqing, China
| | - Peihui Han
- Research Institute of Exploration and Development of Daqing Oilfield Company Ltd, Heilongjiang, Daqing, China
| | - Ruibo Cao
- Research Institute of Exploration and Development of Daqing Oilfield Company Ltd, Heilongjiang, Daqing, China
| | - Tianhan Xu
- School of Petroleum Engineering, Northeast Petroleum University, Heilongjiang, Daqing, China
| | - Wenzhuo Li
- School of Petroleum Engineering, Northeast Petroleum University, Heilongjiang, Daqing, China
| | - Hongyu Zhang
- School of Petroleum Engineering, Northeast Petroleum University, Heilongjiang, Daqing, China
| | - Siqi Zhang
- School of Petroleum Engineering, Northeast Petroleum University, Heilongjiang, Daqing, China
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Comparison of the clinical performance of i-gel and Ambu AuraGain in children. Eur J Anaesthesiol 2019; 36:411-417. [DOI: 10.1097/eja.0000000000000987] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Reddy AM, Varghese N, Herekar B, Shenoy UK. Does prewarming of i-gel improve insertion and ventilation in anaesthetised and paralysed patients? A prospective, randomised, control trial. Saudi J Anaesth 2019; 13:215-221. [PMID: 31333366 PMCID: PMC6625302 DOI: 10.4103/sja.sja_110_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Context: I-gel are supraglottic airway devices with non-inflatable gel-like cuff that is believed to mould to body temperature, to seal the airway. Hence a pre-warmed i-gel may seal faster, provide better ventilation and superior leak pressure. Aims: To determine if pre-warming i-gel to 40°C improves insertion and efficacy of ventilation. Methods and Materials: A prospective, randomised, controlled trial was done on 64 patients requiring anaesthesia with muscle relaxation for short duration. For those in group W, i-gel warmed to 40°C for 15 minutes before insertion was used, whereas for those in group C, i-gel kept at room temperature (approximately 23°C) was used. The airway sealing pressure over time, number of attempts and time taken for a successful insertion were noted. Statistical Analysis: Mean sealing pressure between two groups was compared using independent sample t-test. Repeated Measures ANOVA was used to analyse mean sealing pressure at 0, 15 and 30 min. P value ≤0.05 was considered statistically significant. Results: Sealing pressure improves over time in both the groups but the mean sealing pressure was higher in group C when compared to group W at all points of time, however this was clinically and statistically insignificant. Ease of insertion, time for successful insertion, insertion attempts, intra-operative manoeuvres were all comparable between the groups with no adverse effects. Conclusions: Pre-warming of i-gel to 40°C does not improve the success rate of insertion or provide a higher sealing pressure in anaesthetised and paralysed patients when compared to i-gel at room temperature.
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Affiliation(s)
| | - Nita Varghese
- Department of Anaesthesiology, Kasturba Medical College, Manipal, Karnataka, India
| | - Basavaraj Herekar
- Department of Anaesthesiology, Kasturba Medical College, Manipal, Karnataka, India
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