A survey of current practice of supraglottic airway devices in pediatric anesthesia from India

Abstract

Background and Objectives:Supraglottic airway devices (SADs) have revolutionized the pediatric anesthetic practice and got a key role in difficult airway (DA) management. Several modifications of SADs design had come up to improve their safety.Aim:The aim of this survey was to determine the current usage of SADs in pediatric anesthetic practice, their availability, and to know any difficulties noted in practice.Methods:It was a questionnaire survey among the anesthesiologists who attended the National Pediatric Anesthesia Conference-2016. The questionnaire assessed the current practice preferences of SADs in routine pediatric cases and DA management, availability of various devices, and any difficulties noted in their usage.Results:First-generation SADs were widely available (97%), and 64% of respondents preferred to use it for pediatric short cases. 64% felt the use of SADs free their hands from holding the facemask and 58% found better airway maintenance with it. Intraoperative displacement (55%) was the common problem reported and only 11% felt aspiration as a problem. Most of the respondents (73%) accepted its use as rescue device in airway emergency, and 84% felt the need of further randomized controlled studies on safety of SADs in children. The majority were not confident to use SADs in neonates.Interpretation and Conclusions:The key role of SADs in DA management was well accepted, and aspiration was not a major problem with the use of SADs. Although many newer versions of SADs are available, classic laryngeal mask remains the preferred SAD for the current practitioner. Further, RCTs to ensure the safety of SADs in children are warranted.

A survey of current practice of difficult airway management and equipment in pediatric anesthesia

“…In the present study, 30.3% of respondents had available fiberoptic bronchoscope, and 27.9% had experience with children in this technique. SAD are frequently used in pediatric anesthesia [7]. In our study, general anesthesia with LMA in pediatric cases was preferred by 86.7% of participants in the short-term surgeries.…”

“…First-generation SAD were frequently present (97%), and 64% of the participants preferred to use it for short-term pediatric surgeries. They found that intraoperative displacement (55%) was a common problem and 11% of the participants found aspiration as a problem [7]. In our survey, the frequency of using SAD in pediatric short cases was 86.7% and the causes limiting their use were headed by the inability to do aspiration.…”

“…In our study, the difficulties of using SDA were as reported in the literature, mostly experienced during aspiration and intraoperative displacement. Kaniyil et al [7] reported a questionnaire survey among the anesthesiologists who participated in the National Pediatric Anesthesia Conference in 2016. The questionnaire evaluated the practice preferences of SAD in pediatric anesthesia and difficult airway management, availability of devices, and any difficulties in their usage.…”

“…Anesthesiologists have to identify their strategies for the CICO rescue events and should increase their experience. Kaniyil et al [7] reported that most of their respondents (84%) felt the need for further randomized controlled studies on the safety of SAD in children. Similarly, in our survey, 85.6% of the participants admitted the need for further studies in this subject.…”

Current practice patterns of supraglottic airway device usage in paediatric patients amongst anaesthesiologists: A nationwide survey

“…[ 5 9 ] However, there is a dearth of comprehensive large-scale pan-Indian data. [ 10 ] AAGBI survey focussed mainly on the choice of SGADs and their use in difficult airway. SPA survey concentrated mainly on practice patterns pertaining to LMA family.…”