Comparison of laryngeal mask airway Supreme and laryngeal mask airway Pro-Seal for controlled ventilation during general anaesthesia in adult patients

Maitra, Souvik; Khanna, Puneet; Baidya, Dalim Kumar

doi:10.1097/01.eja.0000435015.89651.3d

Cited by 53 publications

(39 citation statements)

References 25 publications

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“…Oropharyngeal leak pressure, which is one of the most important outcomes here, can vary according to the methods of measurement (e.g. palpable vs audible leak) . The use of a neuromuscular blocker may also change oropharyngeal leak pressure, but the small number of trials using these agents precluded the possibility of a subgroup analysis.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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SummaryPrevious comparisons between the Ambu â AuraOnce TM and other laryngeal mask airways have revealed different results across various clinical studies. We aimed to perform a systematic review with meta-analysis on the efficacy and safety of the AuraOnce compared with other laryngeal mask airways for airway maintenance in adults undergoing general anaesthesia. Our search of PubMed, PubMed Central, Scopus and the Central Register of Clinical Trials of the Cochrane Collaboration yielded nine randomised controlled trials eligible for inclusion. Comparator laryngeal mask airways were the LMA Unique TM (four trials), the LMA Classic â (five trials) and the Portex â Soft Seal â (three trials). The AuraOnce provided an oropharyngeal leak pressure higher than the LMA Unique (304 participants, mean (95% CI) difference 3.1 (1.6-4.7) cmH 2 O, p < 0.0001) and equivalent to the LMA Classic. The Soft Seal provided a higher leak pressure than the AuraOnce (229 participants, mean (95% CI) difference 3.5 (0.4-6.7) cmH 2 O, p = 0.03). Insertion was significantly faster with the AuraOnce than the LMA Unique (304 participants, mean (95% CI) difference 5.4 (2.1-8.71) s, p = 0.001) and Soft Seal (229 participants, mean (95% CI) difference 9.5 (3.0-15.9) s, p = 0.004), but similar to the LMA Classic. The first-insertion success rate of the AuraOnce was equivalent to the LMA Unique, LMA Classic and Soft Seal. We found a higher likelihood of bloodstaining on the cuff with the Soft Seal and a higher incidence of sore throat with the LMA Classic. We conclude that the AuraOnce is an effective alternative to the LMA Classic and LMA Unique, and easier to insert than all three other devices studied.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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“…The second-generation SADs with the higher sealing pressures and tube for gastric drainage should be preferred due to their increased safety and efficacy as compared to the first-generation devices. [373839404142434445] If initial insertion of the SAD fails, changing over to another type of SAD has been shown to be successful. [46] Cricoid pressure interferes with SAD insertion by reducing the hypopharyngeal space, and therefore it should be removed.…”

Section: Optimising Endotracheal Intubationmentioning

confidence: 99%

All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in adults

et al. 2016

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The All India Difficult Airway Association (AIDAA) guidelines for management of the unanticipated difficult airway in adults provide a structured, stepwise approach to manage unanticipated difficulty during tracheal intubation in adults. They have been developed based on the available evidence; wherever robust evidence was lacking, or to suit the needs and situation in India, recommendations were arrived at by consensus opinion of airway experts, incorporating the responses to a questionnaire sent to members of the AIDAA and the Indian Society of Anaesthesiologists. We recommend optimum pre-oxygenation and nasal insufflation of 15 L/min oxygen during apnoea in all patients, and calling for help if the initial attempt at intubation is unsuccessful. Transnasal humidified rapid insufflations of oxygen at 70 L/min (transnasal humidified rapid insufflation ventilatory exchange) should be used when available. We recommend no more than three attempts at tracheal intubation and two attempts at supraglottic airway device (SAD) insertion if intubation fails, provided oxygen saturation remains ≥ 95%. Intubation should be confirmed by capnography. Blind tracheal intubation through the SAD is not recommended. If SAD insertion fails, one final attempt at mask ventilation should be tried after ensuring neuromuscular blockade using the optimal technique for mask ventilation. Failure to intubate the trachea as well as an inability to ventilate the lungs by face mask and SAD constitutes ‘complete ventilation failure’, and emergency cricothyroidotomy should be performed. Patient counselling, documentation and standard reporting of the airway difficulty using a ‘difficult airway alert form’ must be done. In addition, the AIDAA provides suggestions for the contents of a difficult airway cart.

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“…Safety of any supraglottic airway device is determined mainly by its OLP and also indicates the feasibility of positive-pressure ventilation. [1314] A number of randomized clinical trials and a meta-analysis also reported that OLP between i-gel™ and LMA-S™ is similar. [678915] On the contrary to our findings, Chew et al .…”

Section: Discussionmentioning

confidence: 99%

Comparison of oropharyngeal leak pressure of air-Q™,i-gel™, and laryngeal mask airway supreme™ in adult patients during general anesthesia: A randomized controlled trial

et al. 2017

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Study Objective:Various randomized controlled trials and a meta-analysis have compared i-gel™ and laryngeal mask airway Supreme™ (LMA-S™) in adult patients and found that both the devices provided equivalent oropharyngeal leak pressure (OLP). However, no randomized controlled trial has compared air-Q™ with i-gel™ and LMA-S™ in adult patient. Hence, we designed this study to compare air-Q™ with LMA-S™ and i-gel™ in adult patients.Materials and Methods:A total of 75 adult patients of the American Society of Anesthesiologists physical status I/II of both sexes, between 18 and 60 years, were included in this prospective randomized controlled trial conducted in a tertiary care center. Randomization of patients was done in three equal groups according to the insertion of supraglottic airway device by a computer-generated random number sequence: group air-Q™ (n = 25), group i-gel™ (n = 25), and group LMA-S™ (n = 25). Primary outcome of this study was OLP. We also recorded time for successful placement of device, ease of device insertion, number of attempts to insert device, and ease of gastric tube insertion along with postoperative complications.Results:The mean ± standard deviation OLP of air-Q™, i-gel™, and LMA-S™ was 26.13 ± 4.957 cm, 23.75 ± 5.439 cm, and 24.80 ± 4.78 cm H2O (P = 0.279). The first insertion success rate for air-Q™, i-gel™, and LMA-S™ was 80%, 76%, and 92%, respectively (P = 0.353). The insertion time of air-Q™, i-gel™, and LMA-S™ was 20.6 ± 4.4, 14.8 ± 5.4, and 15.2 ± 4.7 s, respectively (P = 0.000). Time taken for air-Q™ insertion was significantly higher than time taken for i-gel™ (mean difference 5.8 s, P < 0.0001) and LMA-S™ (mean difference 5.4 s, P = 0.0001) insertion. Postoperative complications were similar with all three devices.Conclusions:We concluded that air-Q™, i-gel™, and LMA-S™ were equally efficacious in terms of routine airway management in adult patients with normal airway anatomy.

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Comparison of laryngeal mask airway Supreme and laryngeal mask airway Pro-Seal for controlled ventilation during general anaesthesia in adult patients

Cited by 53 publications

References 25 publications

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

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

All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in adults

Comparison of oropharyngeal leak pressure of air-Q™,i-gel™, and laryngeal mask airway supreme™ in adult patients during general anesthesia: A randomized controlled trial

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Comparison of laryngeal mask airway Supreme and laryngeal mask airway Pro-Seal for controlled ventilation during general anaesthesia in adult patients

Cited by 53 publications

References 25 publications

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

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

All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in adults

Comparison of oropharyngeal leak pressure of air-Q™,i-gel™, and laryngeal mask airway supreme™ in adult patients during general anesthesia: A randomized controlled trial

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Product

Resources

About

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

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