1
|
Rana S, Anand LK, Singh M, Kapoor D, Gupta D, Kaur H. Comparative evaluation of self-pressurized Air-Q ® and Proseal™ LMA ® in patients undergoing elective surgery under general anaesthesia: A randomized clinical trial. J Anaesthesiol Clin Pharmacol 2024; 40:336-343. [PMID: 38919429 PMCID: PMC11196046 DOI: 10.4103/joacp.joacp_248_22] [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: 07/13/2022] [Accepted: 03/21/2023] [Indexed: 06/27/2024] Open
Abstract
Background and Aims Intra-cuff pressure of Air-Q self-pressurized laryngeal airways (Air-Q SP) balances airway pressure and adapts to patient's pharyngeal and periglottic structures, thus improves oropharyngeal leak pressure (OLP).This study was performed to compare efficacy of Air-Q SP with Proseal laryngeal mask airway (PLMA) in patients undergoing elective surgery. Material and Methods The study design was prospective, randomized and controlled. Ninety patients were randomly assigned to Air-Q SP or PLMA group. All patients were premedicated and shifted to operation theatre. Monitoring was instituted. After securing IV-line, induction with inj. Morphine + Propofol, relaxation with inj. Vecuronium was done. Supraglottic was inserted according to group allocation. Outcome measures were OLP, fibreoptic view of larynx, success rate, device insertion parameters, haemodynamic and respiratory parameters and post-operative laryngopharyngeal complications. Neostigmine + glycopyrrolate were given, device was extubated. Results All supraglottic airway devices (SADs) were successfully placed in two attempts. The mean initial OLP, OLP at 10 minutes, and device insertion time were significantly lower in Air-Q SP group. Fiber-optic laryngeal view grading was significantly better with Air-Q SP. No significant difference was observed with respect to rate of successful insertion in first attempt, ease of insertion, and manipulations required. The hemodynamic/respiratory parameters and post-operative sore throat in the two both groups were similar. Conclusions Proseal LMA has a higher OLP than Air-Q SP but average insertion time was better, and fiber-optic grading of laryngeal view was shorter with Air-Q SP. However, Air-Q SP and Proseal LMA were both effective for lung ventilation.
Collapse
Affiliation(s)
- Savita Rana
- Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India
| | - Lakesh Kumar Anand
- Department of Anaesthesia, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Manpreet Singh
- Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India
| | - Dheeraj Kapoor
- Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India
| | - Deepika Gupta
- Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India
| | - Harpreet Kaur
- Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India
| |
Collapse
|
2
|
Flynn SG, Stein ML, Fiadjoe JE. Supraglottic Airways, Tennis, and Neonatal Resuscitation. Pediatrics 2022; 150:188755. [PMID: 35948629 DOI: 10.1542/peds.2022-057567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/24/2022] Open
|
3
|
Sawa T, Kainuma A, Akiyama K, Kinoshita M, Shibasaki M. Difficult Airway Management in Neonates and Infants: Knowledge of Devices and a Device-Oriented Strategy. Front Pediatr 2021; 9:654291. [PMID: 34026688 PMCID: PMC8138561 DOI: 10.3389/fped.2021.654291] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/08/2021] [Indexed: 11/13/2022] Open
Abstract
Difficult airway management (DAM) in neonates and infants requires anesthesiologists and critical care clinicians to respond rapidly with appropriate evaluation of specific situations. Therefore, organizing information regarding DAM devices and device-oriented guidance for neonate and infant DAM treatment will help practitioners select the safest and most effective strategy. Based on DAM device information and reported literature, there are three modern options for DAM in neonates and infants that can be selected according to the anatomical difficulty and device-oriented strategy: (1) video laryngoscope (VLS), (2) supraglottic airway device (SAD), and (3) flexible fiberoptic scope (FOS). Some VLSs are equipped with small blades for infants. Advanced SADs have small sizes for infants, and some effectively function as conduits for endotracheal intubation. The smallest FOS has an outer diameter of 2.2 mm and enables intubation with endotracheal tubes with an inner diameter of 3.0 mm. DAM in neonates and infants can be improved by effectively selecting the appropriate device combination and ensuring that available providers have the necessary skills.
Collapse
Affiliation(s)
- Teiji Sawa
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsushi Kainuma
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Akiyama
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Anesthesia, Yodogawa Christian Hospital, Osaka, Japan
| | - Mao Kinoshita
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masayuki Shibasaki
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
4
|
Lee JS, Kim DH, Choi SH, Ha SH, Kim S, Kim MS. Prospective, Randomized Comparison of the i-gel and the Self-Pressurized air-Q Intubating Laryngeal Airway in Elderly Anesthetized Patients. Anesth Analg 2020; 130:480-487. [PMID: 30320644 DOI: 10.1213/ane.0000000000003849] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Age-related changes in upper airway anatomy may affect the overall performance of supraglottic airways significantly. The clinical performance of the i-gel and the self-pressurized air-Q intubating laryngeal airways with noninflatable cuffs for elderly populations remains unknown, unlike in children. Thus, we performed a prospective, randomized comparison of these 2 supraglottic airways in elderly patients undergoing general anesthesia. METHODS We recruited 100 patients, 65-90 years of age, who were scheduled for elective surgery under general anesthesia with muscle relaxation. The enrolled patients were allocated to the i-gel or self-pressurized air-Q group. We assessed oropharyngeal leak pressure as the primary outcome and fiberoptic view after placement and fixation of the airway and at 10 minutes after the initial assessment. The fiberoptic view was scored using a 5-point scale as follows: vocal cords not visible; vocal cords and anterior epiglottis visible, >50% visual obstruction of epiglottis to vocal cords; vocal cords and anterior epiglottis visible, <50% visual obstruction of epiglottis to vocal cords; vocal cords and posterior epiglottis visible; and vocal cords visible. We also investigated success rate and ease of insertion, insertion time, and manipulations during insertion as insertion variables, complications during maintenance and emergence periods, and postoperative pharyngolaryngeal complications including sore throat, dysphagia, and dysphonia. RESULTS After assessing for eligibility, 48 patients were allocated to each group. Oropharyngeal leak pressures were significantly higher in the i-gel group than in the self-pressurized air-Q group (P < .001) at the 2 measurement points. The raw mean difference at initial assessment and the median difference after 10 minutes were 5.5 cm H2O (95% confidence interval, 3.3-7.6 cm H2O) and 5.0 (95% confidence interval, 2.0-7.0 cm H2O), respectively. The initial scores of fiberoptic view were similar in the 2 groups. However, the self-pressurized air-Q supraglottic airway provided a significantly improved fiberoptic view at 10 minutes after initial assessment (P = .030). We found no statistically significant differences in insertion variables and complications between the 2 groups. CONCLUSIONS The i-gel provided better sealing function than the self-pressurized air-Q supraglottic airway according to the high oropharyngeal leak pressures in elderly patients during general anesthesia. The self-pressurized air-Q supraglottic airway had improved fiberoptic views in elderly patients during general anesthesia.
Collapse
Affiliation(s)
- Jeong Soo Lee
- From the Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | |
Collapse
|
5
|
Rangaswamy TM, Bharadwaj A, Jain P. Clinical evaluation of Ambu ® Aura-i™ - A new intubating laryngeal mask airway as an independent ventilatory device and a conduit for tracheal intubation in pediatric patients. Int J Crit Illn Inj Sci 2019; 9:157-163. [PMID: 31879601 PMCID: PMC6927132 DOI: 10.4103/ijciis.ijciis_11_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 08/01/2019] [Accepted: 10/16/2019] [Indexed: 11/18/2022] Open
Abstract
Background: Ambu® Aura-i™, a recently introduced second generation supraglottic airway device has been designed to function as an independent ventilatory device as well as a conduit for passage of conventional cuffed tracheal tubes through it. There is dearth of literature on experience of tracheal intubation through intubating laryngeal mask airway (ILMA) in paediatric age group. This study was conducted to study the ventilatory effectiveness and the intubating characteristics of Ambu® Aura-i™ in paediatric patients. Aim: To study the effectiveness of Ambu ® Aura-i ™ as a supraglottic device for its ventilatory effectiveness and intubation characteristics in paediatric patients. Objectives: To study the Ventilatory effectiveness of Ambu ® Aura-i ™ in terms of: 1) Time taken in insertion of Ambu ® Aura-i ™. 2) No of attempts made for successful insertion of Ambu ® Aura-i™. 3) Tidal volume attained on positive pressure ventilation. 4) Etco2, Spo2 and Leak pressure achieved. To study the Intubating characterstics of Ambu ® Aura-i ™ in terms of :- 1) Grade of alignment of the ventilating orifice achieved in relation to the larynx in the fibre optic view. 2) Time taken in intubation through Ambu ® Aura-i ™. 3) Number of attempts made in intubation. 4) Time taken for removal of the Ambu ® Aura-i ™ after intubation through it has been accomplished. Method: Sixty three children undergoing elective surgery under general anaesthesia requiring intubation of trachea, weighing between 5-30 kg were stratified into 3 groups (n= 21) each. Ambu® Aura-i™ size 1.5 , 2.0 ,2.5 were used based on their body weight for airway management. Ventilatory effectiveness was studied in terms of success rate, number of attempts made at insertion, time taken in insertion, tidal volume delivered and leak pressure achieved. Intubating characterstics studied during fibreoptic guided tracheal intubation included grade of alignment of the ventilating orifice achieved in relation to the larynx in fibre optic view, time taken in fibreoptic guided tracheal intubation, success rate and number of attempts made at intubation. Time taken in removal of the device and complications observed were also recorded. Results: Ambu® Aura-i™ insertion, fibreoptic guided tracheal intubation and device removal were successful in all the patients in first attempt. The mean time taken in successful device insertion was 10.83±2.04 sec. The mean tidal volume delivered was 7.88±1.33 ml/kg body weight and mean leak pressure achieved was 16.27±5.2 cm H2O. The fibreoptic guided intubation was possible in first attempt in 100% of the patients (n=63). The Fibre optic view was grade 1 in 82.55% patients (n=52 /63) and grade 2 in 17.46% (n=11/ 63) patients. The mean time taken in fibre optic guided intubation was 12.68 ±2.82 sec. The mean time taken in removal of the device over the tracheal tube was 12.27 sec. There was no significant incidence of trauma to soft tissues, sore throat, laryngospasm or hoarseness of voice. Conclusion: On the basis of observations of this study, we conclude that Ambu ® Aura-i ™ is not only an effective ventilatoy device, but also an excellent conduit for fibre optic guided intubation using conventional uncuffed endotracheal tube in paediatric patients. Ambu ® Aura-i ™ , is also valuable for establishing rapid airway access in emergent difficult paediatric airway.
Collapse
Affiliation(s)
- Triveni M Rangaswamy
- Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Avnish Bharadwaj
- Department of Anaesthesiology, Mahatma Gandhi University of Medical Services and Technology, Jaipur, Rajasthan, India
| | - Priyanka Jain
- Department of Anaesthesiology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
| |
Collapse
|
6
|
Elganzouri A, Marzouk S, Youssef MM, Abdelalem N. The use of AIR-Q as conduit for fiberoptic endotracheal intubation in adult paralyzed patients. EGYPTIAN JOURNAL OF ANAESTHESIA 2019. [DOI: 10.1016/j.egja.2012.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A.R. Elganzouri
- Airway Management Training Program, Rush University , Chicago, USA
| | | | | | | |
Collapse
|
7
|
Hwang J, Hong B, Kim YH, Lee WH, Jo Y, Youn S, Lim CS. Comparison of laryngeal mask airway supremeTM as non-inflatable cuff device and self-pressurized air-QTM in children: Randomized controlled non-inferiority study. Medicine (Baltimore) 2019; 98:e14746. [PMID: 30855468 PMCID: PMC6417551 DOI: 10.1097/md.0000000000014746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/28/2018] [Accepted: 02/09/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Supraglottic airway (SGA) device with non-inflatable cuff reduce the airway complications associated with cuff hyperinflation. The aim of the study is to determine whether the default setting of Supreme is as effective as the non-inflatable cuff devices. The oropharyngeal leak pressure was measured and compared between the Supreme and Air-Q, a typical non-inflatable cuff device. We hypothesized that the default setting of Supreme is non-inferior to the the Air-Q self-pressurized (SP) in respect to the oropharyngeal leak pressure. METHODS Eighty-four patients aged 1 to 7 years who were scheduled for general anesthesia, participated in the study. The patients were randomly assigned to Supreme group (n = 41) or Air-Q SP group (n = 43). We considered that the primary outcome, oropharyngeal leak pressure of Supreme group would be non-inferior to the Air-Q SP group, within 3 cmH2O. Other outcomes included tidal volume loss, difficulty of insertion, insertion time, and complications. RESULTS The oropharyngeal leak pressure of the Supreme and Air-Q SP was 19.9 ± 4.1 cm H2O and 17.4 ± 2.9 cm H2O, respectively. The mean differences of 2 devices (Air-Q SP-Supreme) were -2.5 cm H2O, (95% confidence interval [-4.0 to -0.9], P = .002). The upper CI was smaller than the non-inferiorty margin (3 cm H2O). This result suggested that the default setting of Supreme was superior to the Air-Q SP with respect to the oropharyngeal leak pressure. However, there were no significant differences in tidal volume loss over time, ease of device insertion score, insertion time, and complications. CONCLUSIONS The Supreme can be used in the default setting in pediatric patients accordingly in terms of tolerable leak pressure and the stability for mechanical ventilation compared with Air-Q SP.
Collapse
|
8
|
Ha SH, Kim MS, Suh J, Lee JS. Self-pressurized air-Q ® intubating laryngeal airway versus the LMA ® Classic™: a randomized clinical trial. Can J Anaesth 2018. [PMID: 29524199 DOI: 10.1007/s12630-018-1082-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The self-pressurized air-Q® (air-Q SP) intubating laryngeal airway is a relatively new supraglottic airway (SGA) device. The intracuff pressure of air-Q dynamically equilibrates with the airway pressure and adjusts to the patient's pharyngeal and periglottic anatomy, potentially providing improved airway fit and seal. The aim of this prospective randomized study was to compare the clinical performance of air-Q to the LMA® Classic™ SGA. METHODS Adult patients requiring general anesthesia for elective surgery were prospectively enrolled and randomly assigned to either air-Q SP or the LMA Classic SGA. Oropharyngeal leak pressure (primary endpoint), success rate, insertion features (insertion time, ease of insertion, requirement for device manipulation), sealing function, gastric insufflation, bronchoscopic view, and oropharyngeal complications at device insertion and following its removal (sore throat, dysphagia, dysphonia) were compared. RESULTS The mean (standard deviation [SD]) oropharyngeal leak pressure just after insertion was similar in the air-Q SP and LMA [16.8 (4.9) vs 18.6 (5.5) cm H2O, respectively; mean difference, 1.8 cm H2O; 95% CI, -0.5 to 4.2; P = 0.13] and did not differ at ten minutes following device insertion. Median [interquartile range (IQR)] peak inspiratory pressure just after insertion was lower in the air-Q SP (11.0 [10.0-13.0] vs 13.0 [11.0-14.0] cmH2O, median difference, 1.0 cm H2O; 95% CI, 0.0 to 2.0; P = 0.03) but no difference was observed at ten minutes. The median [IQR] insertion time was faster with the air-Q SP (15.9 [13.6-20.3] sec vs 24 [21.2-27.1] sec; median difference, 8.1 sec; 95% CI, 5.6 to 9.9; P < 0.001) and improved bronchoscopic viewing grade were seen with the air-Q SP immediately after insertion (P < 0.001). No differences between the groups were observed with respect to the rate of successful insertion at first attempt, overall insertion success rate, ease of insertion, and complications. CONCLUSIONS The air-Q SP had similar leak pressures but a faster insertion time and superior bronchoscopic viewing grade when compared with the LMA Classic. The air-Q SP is a suitable alternative to the LMA Classic in adult patients and may be a superior conduit for tracheal intubation. TRIAL REGISTRATION www.clinicaltrials.gov (NCT02206438). Registered 1 August 2014.
Collapse
Affiliation(s)
- Sang Hee Ha
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.,Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonjuro, Gangna-gu, Seoul, Korea
| | - Min-Soo Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jiwoo Suh
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Seok Lee
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. .,Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonjuro, Gangna-gu, Seoul, Korea.
| |
Collapse
|
9
|
Kleine-Brueggeney M, Gottfried A, Nabecker S, Greif R, Book M, Theiler L. Pediatric supraglottic airway devices in clinical practice: A prospective observational study. BMC Anesthesiol 2017; 17:119. [PMID: 28865448 PMCID: PMC5581452 DOI: 10.1186/s12871-017-0403-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 08/16/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Supraglottic airway devices (SGA) are commonly used in pediatric anesthesia and serve as primary or back-up devices for difficult airway management. Most SGA are marketed without proper clinical evaluation. The purpose of this study was to evaluate the performance of the pediatric LMA Supreme™, Air-Q® and Ambu® Aura-i™. METHODS This prospective observational study was performed at Bern University Hospital, Switzerland. With ethics committee approval and a waiver for written informed consent 240 children undergoing elective surgery with an ASA class I-III and a weight of 5-30 kg were included. Three different pediatric supraglottic airway devices were assessed: The LMA Supreme™, Air-Q® and Ambu® Aura-i™. Primary outcome parameter was airway leak pressure. Secondary outcome parameters included first attempt and overall success rate, insertion time, fiberoptic view through the SGA, and adverse events. The primary hypothesis was that the mean airway leak pressure of each tested SGA was 20 cmH2O ± 10%. RESULTS None of the SGA showed a mean airway leak pressure of 20 cmH2O ± 10%, but mean airway leak pressures differed significantly between devices [LMA Supreme™ 18.0 (3.4) cmH2O, Air-Q® 15.9 (3.2) cmH2O, Ambu® Aura-i™ 17.3 (3.7) cmH2O, p < 0.001]. First attempt success rates (LMA Supreme™ 100%, Air-Q® 90%, Ambu® Aura-i™ 91%, p = 0.02) and overall success rates (LMA Supreme™ 100%, Air-Q® 91%, Ambu® Aura-i™ 95%, p = 0.02) also differed significantly. Insertion times ranged from 20 (7) seconds (Air-Q®) to 24 (6) seconds (LMA Supreme™, <p = 0.005). Insertion was rated easiest with the LMA Supreme™ (very easy in 97% vs. Air-Q® 70%, Ambu® Aura-i™ 72%, p < 0.001). Fiberoptic view was similar between the SGA. Adverse events were rare. CONCLUSIONS Airway leak pressures ranged from 16 to 18 cmH2O, enabling positive pressure ventilation with all successful SGA. The highest success rates were achieved by the LMA Supreme™, which was also rated easiest to insert. TRIALS REGISTRATION ClinicalTrials.gov , identifier NCT01625858 . Registered 31 May 2012.
Collapse
Affiliation(s)
- Maren Kleine-Brueggeney
- Department of Anaesthesiology and Pain Therapy, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland. .,Present address: Department of Anaesthesia, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Anne Gottfried
- Department of Anaesthesiology and Pain Therapy, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Sabine Nabecker
- Department of Anaesthesiology and Pain Therapy, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Robert Greif
- Department of Anaesthesiology and Pain Therapy, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Malte Book
- Department of Anaesthesiology and Pain Therapy, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.,Present address: Department of Anaesthesia, Klinikum Oldenburg AöR, 26133, Oldenburg, Germany
| | - Lorenz Theiler
- Department of Anaesthesiology and Pain Therapy, Inselspital, University Hospital Bern, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| |
Collapse
|
10
|
Kim H, Lee K, Bai S, Kim M, Oh E, Yoo Y. Influence of head and neck position on ventilation using the air-Q ® SP airway in anaesthetized paralysed patients: a prospective randomized crossover study. Br J Anaesth 2017; 118:452-457. [DOI: 10.1093/bja/aew448] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2016] [Indexed: 11/14/2022] Open
|
11
|
Watanabe A, Edanaga M, Ichinose H, Yamakage M. Comparison of the clinical performances of Air-Qsp and i-Gel for airway management under general anesthesia with a muscle relaxant. J Clin Anesth 2016; 34:223-6. [PMID: 27687379 DOI: 10.1016/j.jclinane.2016.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 04/07/2016] [Indexed: 11/15/2022]
Abstract
STUDY OBJECTIVES Recently, i-Gel intubating laryngeal airway (ILA) has been frequently used because of the ease for airway insertion by residents and young anesthesiologists. However, it sometimes fails to fit or ventilate sufficiently in Japanese patients. Use of Air-Qsp, which is a new non-inflatable cuffed ILA, in a clinical setting has become possible. The purpose of this study was to compare the clinical performance of Air-Qsp with that of i-Gel for airway management in Japanese adult patients. DESIGN A randomized, single-blinded, prospective study was conducted after approval from the institutional review board. SETTING Operating rooms at hospitals. PATIENTS Thirty-seven adult patients aged 20 to 69 years, with ASA physical status I or II, and scheduled for elective surgery under general anesthesia in the supine position. INTERVENTIONS Patients were randomly assigned to insertion with Air-Qsp (Group A: n=20) or i-Gel (Group I: n=17). MEASUREMENTS The number of insertions, duration of insertion, changes in systolic blood pressure and heart rate during insertion, delivered tidal volume for setting volume control ventilation, distribution of the tips of the bronchofiberscopes (BFs) on a clock face, and the number of postoperative complications was evaluated. MAIN RESULTS Two patients in Group A and one patient in Group I were excluded because insertion of the device failed. There were no significant differences in measured parameters between the 2 groups. The distribution of the tips of the bronchofiberscopes tended to be around the center of the glottis in Group A, whereas they were more toward the 6-o'clock position in Group I. CONCLUSIONS Air-Qsp is as useful as i-Gel in Japanese patients and the distributions of the tips of BFs through ILAs are different for Air-Qsp and i-Gel.
Collapse
Affiliation(s)
- Asako Watanabe
- Department of Anesthesiology, Sapporo Medical University, School of Medicine.
| | - Mitsutaka Edanaga
- Department of Anesthesiology, Sapporo Medical University, School of Medicine
| | | | - Michiaki Yamakage
- Department of Anesthesiology, Sapporo Medical University, School of Medicine
| |
Collapse
|
12
|
Comparative Efficacy of the Air-Q Intubating Laryngeal Airway during General Anesthesia in Pediatric Patients: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6406391. [PMID: 27419134 PMCID: PMC4935900 DOI: 10.1155/2016/6406391] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 05/24/2016] [Indexed: 11/25/2022]
Abstract
Air-Q® (air-Q) is a supraglottic airway device which can be used as a guidance of intubation in pediatric as well as in adult patients. We evaluated the efficacy and safety of air-Q compared to other airway devices during general anesthesia in pediatric patients by conducting a systematic review and meta-analysis. A total of 10 studies including 789 patients were included in the final analysis. Compared with other supraglottic airway devices, air-Q showed no evidence for a difference in leakage pressure and insertion time. The ease of insertion was significantly lower than other supraglottic airway devices. The success rate of intubation was significantly lower than other airway devices. However, fiberoptic view was better through the air-Q than other supraglottic airway devices. Therefore, air-Q could be a safe substitute for other airway devices and may provide better fiberoptic bronchoscopic view.
Collapse
|
13
|
Malhotra SK, Bharath KV, Saini V. Comparison of success rate of intubation through Air-Q with ILMA using two different endotracheal tubes. Indian J Anaesth 2016; 60:242-7. [PMID: 27141106 PMCID: PMC4840803 DOI: 10.4103/0019-5049.179448] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND AIMS Air-Q™ is a newly introduced airway device, which can be used to facilitate endotracheal intubation. The primary aim of this study was to assess whether use of two different endotracheal tubes (ETTs) (standard polyvinyl chloride [PVC] and reinforced PVC) increases the success rate of blind intubation through Air-Q™ (Group Q) when compared with intubating laryngeal mask airway (ILMA- Fastrach™) keeping ILMA as control (Group I). METHODS One hundred and twenty patients aged between 18 and 60 years with American Society of Anesthesiologists physical status I-II, undergoing elective surgery under general anaesthesia, were enrolled into this prospective, randomised, case-control study to compare the success rate of tracheal intubation between ILMA (Fastrach™) and Air-Q™ intubating laryngeal airway. Those patients with anticipated difficult airway were excluded from the study. All the recruited patients completed the study. Reinforced PVC ETT was used in both airway devices to secure intubation. Since standard PVC tube is recommended for use in Air-Q, when first intubation attempt failed, second or third attempt was made with standard PVC ETT. Total of three attempts were made for each procedure: Whereas in ILMA group, only reinforced tube was used in all three attempts. RESULTS The overall success rate after three attempts was more with Air-Q (96.6%) in our study compared with ILMA (91.6%) but no significant difference was seen between the groups (P = 0.43). CONCLUSION The present study shows that when intubation with reinforced tube fails, the success rate with use of conventional PVC tube is more with Air-Q when compared with ILMA.
Collapse
Affiliation(s)
- S K Malhotra
- Department of Anaesthesia, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - K V Bharath
- Department of Anaesthesia, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikas Saini
- Department of Anaesthesia, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
14
|
Blind intubation of anaesthetised children with supraglottic airway devices AmbuAura-i and Air-Q cannot be recommended. Eur J Anaesthesiol 2015; 32:631-9. [DOI: 10.1097/eja.0000000000000261] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
15
|
Darlong V, Biyani G, Baidya DK, Pandey R, Chandralekha, Punj J, Upadhyay AD. Comparison of air-Q and Ambu Aura-i for controlled ventilation in infants: a randomized controlled trial. Paediatr Anaesth 2015; 25:795-800. [PMID: 25917434 DOI: 10.1111/pan.12663] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND The air-Q is a new supraglottic airway device (SAD) and has been increasingly used as a primary airway device and as a conduit for tracheal intubation in children as well as in adults. This device has either performed equally or better than other SADs in children. The Ambu Aura-i is a commonly used SAD in children undergoing various short surgical procedures. However, limited literature is available evaluating the safety and efficacy of the air-Q and the Ambu Aura-i in small children. We, therefore, conducted this study to compare the clinical performance of these two airway devices in infants weighing up to 10 kg. Our hypothesis is that air-Q, due to its improved and larger cuff design will yield better airway seal pressures as compared with the Ambu Aura-i. METHODS Sixty-four ASA I-II infants weighing <10 kg undergoing elective ophthalmic surgery were randomly assigned to receive either an air-Q or the Ambu Aura-i. After induction of general anesthesia (GA) and muscle relaxation, we measured oropharyngeal leak pressure (OLP) as the primary outcome. The secondary end points measured were time to insert, first insertion success rate, fiberoptic grade (FO) of laryngeal view and any other airway complications like trauma, laryngospasm, and desaturation. RESULTS The air-Q ILA provided significantly higher OLP as compared with the Ambu Aura-i [20.2 ± 4.6 cm H2 O, CI 18.55-21.88; vs 16.2 ± 5.6 cmH2 O, CI 14.27-18.25, P = 0.003; mean difference 4 ± 1.29 cm H2 O, CI 1.41-6.58]. However, the Ambu Aura-i required significantly less time for its insertion (14.6 ± 2.8 s, CI 13.66-15.70; vs 16.3 ± 1.5 s, CI 15.75-16.86, P = 0.005; mean difference 1.625 ± 0.56 s, CI 0.48-2.76). There were no differences in first insertion success rate, FO view, and postoperative complications. CONCLUSION We conclude that air-Q may be considered superior to Ambu Aura-i in infants for controlled ventilation as it provides higher airway sealing pressures.
Collapse
Affiliation(s)
- Vanlal Darlong
- Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ghansham Biyani
- Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dalim K Baidya
- Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra Pandey
- Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India
| | - Chandralekha
- Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India
| | - Jyotsna Punj
- Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish D Upadhyay
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
16
|
|
17
|
Jagannathan N, Ramsey MA, White MC, Sohn L. An update on newer pediatric supraglottic airways with recommendations for clinical use. Paediatr Anaesth 2015; 25:334-45. [PMID: 25585975 DOI: 10.1111/pan.12614] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2014] [Indexed: 11/26/2022]
Abstract
Supraglottic airways are an established part of routine and emergency pediatric airway management, including use in difficult airways and neonatal resuscitation. With the introduction of newer supraglottic airways in children, efficacy can only be determined by comparing these devices with those that are already well established (laryngeal mask airway Classic and laryngeal mask airway ProSeal). This narrative review aims to present the current literature on these newer supraglottic airways and give recommendations for their use in various clinical scenarios based on the existing evidence.
Collapse
Affiliation(s)
- Narasimhan Jagannathan
- Department of Pediatric Anesthesia, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University's Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | |
Collapse
|
18
|
Kim MS, Lee JH, Han SW, Im YJ, Kang HJ, Lee JR. A randomized comparison of the i-gel with the self-pressurized air-Q intubating laryngeal airway in children. Paediatr Anaesth 2015; 25:405-12. [PMID: 25559870 DOI: 10.1111/pan.12609] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Supraglottic airway devices with noninflatable cuff have advantages in omitting the cuff pressure monitoring and reducing potential pharyngolaryngeal complications. Typical devices without cuff inflation available in children are the i-gel and the self-pressurized air-Q intubating laryngeal airway (air-Q SP). To date, there is no comparative study between these devices in pediatric patients. AIM The purpose of this randomized study was to compare the i-gel(™) and the self-pressurized air-Q(™) intubating laryngeal airway (air-Q SP) in children undergoing general anesthesia. METHODS Eighty children, 1-108 months of age, 7-30 kg of weight, and scheduled for elective surgery in which supraglottic airway devices would be suitable for airway management, were randomly assigned to either the i-gel or the air-Q SP. Oropharyngeal leak pressure and fiberoptic view were assessed three times as follows: after insertion and fixation of the device, 10 min after initial assessment, and after completion of surgery. We also assessed insertion parameters and complications. RESULTS Insertion of the i-gel was regarded as significantly easier compared to the air-Q SP (P = 0.04). Compared to the air-Q SP group, the i-gel group had significantly higher oropharyngeal leak pressures at all measurement points and significantly lower frequencies of gastric insufflation at 10 min after initial assessment and completion of surgery. The air-Q SP group had better fiberoptic views than the i-gel group at all measurement points. CONCLUSION Our results showed that the i-gel had easier insertion and better sealing function, and the air-Q SP provided improved fiberoptic views in children requiring general anesthesia.
Collapse
Affiliation(s)
- Min-Soo Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
19
|
Darlong V, Biyani G, Pandey R, Baidya DK, Chandralekha , Punj J. Comparison of performance and efficacy of air-Q intubating laryngeal airway and flexible laryngeal mask airway in anesthetized and paralyzed infants and children. Paediatr Anaesth 2014; 24:1066-71. [PMID: 24961960 DOI: 10.1111/pan.12462] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Flexible laryngeal mask airway is a commonly used supraglotic airway device (SAD) during ophthalmic surgeries. Air-Q intubating laryngeal airway (ILA) is a newer SAD used as primary airway device and as a conduit for intubation as well. Available literature shows that air-Q performs equal or better than other SADs in children and adults. However, limited data is available using air-Q in infants and small children <10 kg. So, our aim was ‘To compare the performance and efficacy of these two devices in infants and small children’. Our hypothesis is that air-Q due to its improved cuff design will yield better airway seal pressures and improved laryngeal alignment as compared to flexible laryngeal mask airway. METHODS ASA I–II infants and children weighing <10 kg, undergoing cataract or glaucoma surgery, were randomly divided into two groups of 25 each. After induction of anesthesia and muscle relaxation, we measured oropharyngeal leak pressure (OLP), fibre-optic (FO) view of glottis, first insertion success rate, time to insert, and any other complications. RESULTS There was no difference between the groups in demographic data, first insertion success rate, time to insert, and postoperative complications. Air-Q provided significantly more OLP [21.1 ± 6.4 cmH2O vs 17.4 ± 4.1 cmH2O, P = 0.02] and better FO view of glottis (good view 84% vs 48%, P = 0.0016) as compared to flexible laryngeal mask airway. CONCLUSION We conclude that air-Q is superior to flexible laryngeal mask airway in providing higher airway sealing pressures and better FO grade of laryngeal view in infants and children.
Collapse
Affiliation(s)
- Vanlal Darlong
- Department of Anesthesiology; All India Institute of Medical Sciences; New Delhi India
| | - Ghansham Biyani
- Department of Anesthesiology; All India Institute of Medical Sciences; New Delhi India
| | - Ravindra Pandey
- Department of Anesthesiology; All India Institute of Medical Sciences; New Delhi India
| | - Dalim K. Baidya
- Department of Anesthesiology; All India Institute of Medical Sciences; New Delhi India
| | - Chandralekha
- Department of Anesthesiology; All India Institute of Medical Sciences; New Delhi India
| | - Jyotsna Punj
- Department of Anesthesiology; All India Institute of Medical Sciences; New Delhi India
| |
Collapse
|
20
|
Galgon RE, Schroeder K, Joffe AM. The self-pressurising air-Q® Intubating Laryngeal Airway for airway maintenance during anaesthesia in adults: a report of the first 100 uses. Anaesth Intensive Care 2012. [PMID: 23194212 DOI: 10.1177/0310057x1204000614] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The self-pressurising air-Q® Intubating Laryngeal Airway is a new, commercially available, supraglottic airway device that incorporates a self-regulating periglottic cuff. In this retrospective review, we describe our initial clinical experience using the device in 100 patients. The ease and number of insertion attempts, airway seal pressure, device positioning, intubation success and oropharyngeal morbidity were recorded. The air-Q Intubating Laryngeal Airway was successfully inserted in all 100 patients and functioned adequately as a primary airway in 70 of the 72 patients in which it was used for this purpose. The median (interquartile range [range]) airway seal pressure was 22 (19-29, [10-40]) cmH2O. Intubation via the air-Q Intubating Laryngeal Airway was successful in 28 of 29 (97%) patients. Eleven percent of patients complained of sore throat postoperatively before discharge. In our series, the air-Q Intubating Laryngeal Airway performed adequately as a primary airway during anaesthesia with respect to ease of insertion, adequacy of airway maintenance and as a conduit for intubation in both anticipated and unanticipated difficult airways. Although our initial experience is positive, further investigation with larger numbers of observations are needed as the upper limits of the 95% confidence intervals for device failure (the worst failure rate the clinician could expect) are still high.
Collapse
Affiliation(s)
- R E Galgon
- Department of Anesthesiology and Pain Medicine, University of Washington, Harborview Medical Center, Seattle, WA 98104, USA
| | | | | |
Collapse
|
21
|
Jagannathan N, Sohn LE, Sawardekar A, Gordon J, Shah RD, Mukherji II, Roth AG, Suresh S. A randomized trial comparing the Ambu ® Aura-i ™ with the air-Q ™ intubating laryngeal airway as conduits for tracheal intubation in children. Paediatr Anaesth 2012; 22:1197-204. [PMID: 22971118 DOI: 10.1111/pan.12024] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the clinical performance of the Ambu Aura-i (Aura-i) in children. AIM To compare the Aura-i with the air-Q intubating laryngeal airway (air-Q) for the purposes of fiberoptic-guided tracheal intubation. BACKGROUND The Aura-i is a new supraglottic airway designed for tracheal intubation. MATERIALS/METHODS One hundred twenty children, ages 1 month to 6 years, were randomized to receive either the Aura-i or air-Q, and divided into three equal subgroups (Group 1, 2, 3) based on weight. The time for successful tracheal intubation was primarily assessed. The ease, time, and number of attempts for successful device insertion, leak pressures, fiberoptic grade of laryngeal view, number of attempts time for removal of the device after tracheal intubation, and complications were secondarily assessed. RESULTS Device placement, tracheal intubation, and removal after tracheal intubation were successful in all patients. There were no differences in the time to successful tracheal intubation through the Aura-i (32.9 ± 13.3 s), and the air-Q (33.9 ± 13 s; P = 0.68), or fiberoptic grade of view between devices. There was not a statistically significant correlation between the time to intubation and the fiberoptic grade of laryngeal view in any of the groups. There were no statistically significant differences in the overall leak pressures, air-Q (18.3 ± 6.1 cm H(2) O) vs Aura-i (16 ± 5.1 cm H(2) O; P = 0.05). In Group 1 (5-10 kg), leak pressures were higher with the air-Q (23.4 ± 7.2 cm H(2) O) than the Aura-i (16.1 ± 5.2 cm H(2) O; P = 0.001). There were no statistically significant differences in the time for removal between the two devices (P = 0.11). However, with the size 1.5 Aura-i, the pilot balloon of the tracheal tube was removed in order to facilitate the removal of the device after tracheal intubation. CONCLUSIONS Both devices served as effective conduits for fiberoptic-guided tracheal intubation. The limitation of the narrower proximal airway tube of the size 1.5 Aura-i should be considered if cuffed tracheal tubes are to be utilized.
Collapse
Affiliation(s)
- Narasimhan Jagannathan
- Department of Pediatric Anesthesia, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University's Feinberg School of Medicine, Chicago, IL 60611, USA.
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
Modern anaesthesia practice in children was made possible by the invention of the endotracheal tube (ET), which made lengthy and complex surgical procedures feasible without the disastrous complications of airway obstruction, aspiration of gastric contents or asphyxia. For decades, endotracheal intubation or bag-and-mask ventilation were the mainstays of airway management. In 1983, this changed with the invention of the laryngeal mask airway (LMA), the first supraglottic airway device that blended features of the facemask with those of the ET, providing ease of placement and hands-free maintenance along with a relatively secure airway. The invention and development of the LMA by Dr. Archie Brain has had a significant impact on the practice of anaesthesia, management of the difficult airway and cardiopulmonary resuscitation in children and neonates. This review article will be a brief about the clinical applications of supraglottic airways in children.
Collapse
Affiliation(s)
- S Ramesh
- Department of Anaesthesia, Senior Consultants, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India
| | | |
Collapse
|
23
|
Jagannathan N, Sohn LE, Chang E, Sawardekar A. A cohort evaluation of the laryngeal mask airway-Supreme™ in children. Paediatr Anaesth 2012; 22:759-64. [PMID: 22416790 DOI: 10.1111/j.1460-9592.2012.03832.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the clinical performance of the laryngeal mask airway-Supreme in children. AIM The purpose of this prospective audit was to evaluate the feasibility of the laryngeal mask airway-Supreme in clinical practice and generate data for future comparison trials. BACKGROUND The laryngeal mask airway-Supreme is a new second-generation supraglottic airway that was recently released in limited pediatric sizes (sizes 1, 2). METHODS One hundred children, ASA I-III, newborn to 16 years of age, and undergoing various procedures requiring a size 1, 2, or 3 laryngeal mask airway-Supreme were studied. Assessments included insertion success rates, airway leak pressures, success of gastric tube insertion, quality of airway, and perioperative complications. RESULTS The first-time insertion success rate was 97%, with an overall insertion success rate of 100%. The mean initial airway leak pressure for all patients was 22.3 ± 6.6 cm H(2) O. Gastric tube placement was possible in 98% of patients. Complications were noted in six patients: coughing or laryngospasm (n = 3), sore throat (n = 1), and dysphonia (n = 2). CONCLUSIONS The laryngeal mask airway-Supreme was inserted with a high degree of success on the first attempt by clinicians with limited prior experience with the device. It was effectively used for a variety of procedures in children undergoing spontaneous and mechanical ventilation with minimal complications. The leak pressures demonstrated in this study, along with access for gastric decompression, suggest that the laryngeal mask airway-Supreme may be an effective device for positive pressure ventilation in children.
Collapse
Affiliation(s)
- Narasimhan Jagannathan
- Department of Pediatric Anesthesiology, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL 60614, USA.
| | | | | | | |
Collapse
|
24
|
Jagannathan N, Sohn LE, Sawardekar A, Shah R, Ryan K, Jagannathan R, Anderson K. A randomised comparison of the self-pressurised air-QTM intubating laryngeal airway with the LMA UniqueTM in children*. Anaesthesia 2012; 67:973-9. [DOI: 10.1111/j.1365-2044.2012.07199.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
25
|
Bibliography. Opbstetric and gynecological anesthesia. Current world literature. Curr Opin Anaesthesiol 2012; 25:389-92. [PMID: 22552532 DOI: 10.1097/aco.0b013e328354632f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|