Comparative efficacy and safety of the Ambu<sup>®</sup> AuraOnce<sup>™</sup> laryngeal mask airway during general anaesthesia in adults: a systematic review and meta‐analysis

Baidya, Dalim Kumar; Chandralekha,; Darlong, Vanlal; Pandey, Ravindra K.; Maitra, Souvik; Khanna, Puneet

doi:10.1111/anae.12682

Cited by 14 publications

(12 citation statements)

References 20 publications

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“…There was no significant difference with the LMA laryngeal mask Supreme and the SLIPA compared with the LMA laryngeal mask Classic ™ . The incidence of postoperative sore throat with the Ambu ® AuraOnce ™ (Ambu, Ballerup, Denmark) is also comparable to first generation SADs, including the LMA laryngeal mask Classic, LMA laryngeal mask Unique and the Soft Seal LMA laryngeal mask , but higher than the i‐gel .…”

Section: Methodsmentioning

confidence: 85%

Postoperative sore throat: a systematic review

2016

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Summary Postoperative sore throat has a reported incidence of up to 62% following general anaesthesia. In adults undergoing tracheal intubation, female sex, younger age, pre‐existing lung disease, prolonged duration of anaesthesia and the presence of a blood‐stained tracheal tube on extubation are associated with the greatest risk. Tracheal intubation without neuromuscular blockade, use of double‐lumen tubes, as well as high tracheal tube cuff pressures may also increase the risk of postoperative sore throat. The expertise of the anaesthetist performing tracheal intubation appears to have no influence on the incidence in adults, although it may in children. In adults, the i‐gel™ supraglottic airway device results in a lower incidence of postoperative sore throat. Cuffed supraglottic airway devices should be inflated sufficiently to obtain an adequate seal and intracuff pressure should be monitored. Children with respiratory tract disease are at increased risk. The use of supraglottic airway devices, oral, rather than nasal, tracheal intubation and cuffed, rather than uncuffed, tracheal tubes have benefit in reducing the incidence of postoperative sore throat in children. Limiting both tracheal tube and supraglottic airway device cuff pressure may also reduce the incidence.

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Section: Methodsmentioning

confidence: 85%

Postoperative sore throat: a systematic review

2016

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“…When clinical circumstances and provider competence allow, the SAD can be converted to a definitive tracheal tube reflecting the stepwise approach to airway management involving multiple techniques during a single resuscitation . Several second‐generation SAD models exist but evidence is inconclusive on the preferred model . The task force does not recommend any specific second‐generation model, but emphasises that EMS providers should be appropriately trained in inserting the specific device(s) in use by their service.…”

Section: Resultsmentioning

confidence: 99%

Scandinavian SSAI clinical practice guideline on pre‐hospital airway management

Rehn

Hyldmo

Magnússon

et al. 2016

Acta Anaesthesiol Scand

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BackgroundThe Scandinavian society of anaesthesiology and intensive care medicine task force on pre‐hospital airway management was asked to formulate recommendations following standards for trustworthy clinical practice guidelines.MethodsThe literature was systematically reviewed and the grading of recommendations assessment, development and evaluation (GRADE) system was applied to move from evidence to recommendations.ResultsWe recommend that all emergency medical service (EMS) providers consider to: apply basic airway manoeuvres and airway adjuncts (good practice recommendation); turn unconscious non‐trauma patients into the recovery position when advanced airway management is unavailable (good practice recommendation); turn unconscious trauma patients to the lateral trauma position while maintaining spinal alignment when advanced airway management is unavailable [strong recommendation, low quality of evidence (QoE)]. We suggest that intermediately trained providers use a supraglottic airway device (SAD) or basic airway manoeuvres on patients in cardiac arrest (weak recommendation, low QoE). We recommend that advanced trained providers consider using an SAD in selected indications or as a rescue device after failed endotracheal intubation (ETI) (good practice recommendation). We recommend that ETI should only be performed by advanced trained providers (strong recommendation, low QoE). We suggest that videolaryngoscopy is considered for ETI when direct laryngoscopy fails or is expected to be difficult (weak recommendation, low QoE). We suggest that advanced trained providers apply cricothyroidotomy in ‘cannot intubate, cannot ventilate’ situations (weak recommendation, low QoE).ConclusionThis guideline for pre‐hospital airway management includes a combination of techniques applied in a stepwise fashion appropriate to patient clinical status and provider training.

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“…, Smith & Bailey , and Baidya et al. , may help distill what clinical evidence we do have and identify outcomes for which there is still insufficient evidence.…”

Section: Discussionmentioning

confidence: 99%

“…In the era of evidence‐based medicine, introduction of a new device into clinical practice must be justified first with scientific reasoning. In this and recent issues of Anaesthesia , such evidence is provided by way of three meta‐analyses on the i‐gel ® and one on the Ambu ® AuraOnce ™ .…”

Section: How Can We Choose the ‘Right’ Device?mentioning

confidence: 99%