Laryngeal Mask Airway Supreme vs. the Spritztube tracheal cannula in anaesthetised adult patients

Rationale: Laryngeal obstruction is a life-threatening adverse event that requires urgent and appropriate management, particularly in patients with coexisting cardiopulmonary and brain comorbidities. However, laryngeal obstruction caused by laryngeal neuroendocrine tumors has rarely been reported.Patient concerns: Neuroendocrine tumors can cause pathological changes in the neuro-humoral system, and asphyxia caused by airway obstruction has a more adverse effect on patients with neuroendocrine tumors.Diagnoses: We report the case of a 64-year-old man with clinical manifestations of dyspnea. Preoperative and intraoperative pathological examination indicated that the patient was diagnosed with life-threatening airway obstruction caused by a laryngeal neuroendocrine tumor, pneumonia, and scoliosis. Interventions:The patient underwent laryngeal tumor resection under general anesthesia. He was recovered well and was generally good without the necessity of undergoing radiotherapy and chemotherapy at the 6-months follow-up.Outcomes: This case report has provided an emergency treatment strategy associated with awake intubation. We concluded that flexible establishment of an artificial airway, skilled anesthesia and surgical manipulation, and necessary postoperative intensive care are extremely important for improving the prognosis of patients with severely difficult airway. It is noteworthy that the timely adjust for endotracheal intubation strategy according to the patient's response is needed. It is important for the longterm prognosis of patients to avoid the establishment of a traumatic artificial airway and the occurrence of adverse complications.

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“…In addition, the supraglottic airway device was found inappropriate for this patient due to the almost complete laryngeal obstruction. [7]…”

Section: Discussionmentioning

confidence: 99%

Emergency treatment of airway obstruction caused by a laryngeal neuroendocrine tumor: A case report

Zhang

Yin

2023

Medicine

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“…In the present study, there were no differences in those four diameters between Chinese men weighing 50 to 70 kg and those weighing >70 kg, suggesting that an identically sized Ambu AuraOnce could fit the two groups of patients. Because of the limited space of the anatomical structure of the larynx, even if the size 5 Ambu AuraOnce is larger and can seal the glottis better than smaller masks, 19 there is not enough space for the size 5 Ambu AuraOnce to be adjusted in an ideal position in relation to the glottis. The seal could be easier to achieve with the epiglottis reflexed and blocking the glottis.…”

Section: Discussionmentioning

confidence: 99%

Size selection of the Ambu AuraOnce laryngeal mask in Chinese men weighing >70 kg: a pilot study

Chen

et al. 2021

J Int Med Res

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Objective To collect computed tomography data of the laryngeal anatomy of Chinese men and to determine the feasibility of using the size 4 Ambu AuraOnce laryngeal mask (Ambu A/S, Copenhagen, Denmark) in Chinese men weighing >70 kg. Methods This prospective study involved men who underwent surgery from May 2018 to January 2019 at Jinshan Hospital. Pharyngeal and laryngeal parameters were measured by computed tomography. The laryngeal mask insertion success rate, requirement for tracheal tube insertion, laryngeal mask insertion time, fiberoptic bronchoscopy grading, air leakage pressure, and pharyngeal complications were analyzed. Results In a comparison of the size 4 and 5 Ambu AuraOnce devices, the first insertion success rate was 100% and 87% and the three-times insertion success rate was 100% and 93%, respectively, with no significant differences. However, the insertion time was significantly different at 19.6 ± 5.9 versus 31.1 ± 11.2 s, respectively, and the proportions of fiberoptic grading levels were also significantly different. There were no significant differences in the air leakage pressure or pharyngeal complications. Conclusion The size 4 Ambu AuraOnce is more adequate than the size 5 for Chinese men weighing >70 kg, with a shorter insertion time and higher fiberoptic bronchoscopic grading.

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“…Xiao et al (2016) evaluated the efficacy and safety of an NPA device (n=130) to that of a nasal oxygen tube (n=130) in obese patients receiving general anesthesia and undergoing painless gastroscopy with physician and anesthetist satisfaction of the collective anesthesia protocol reported on a 10-point ordinal scale (22). Recently, De Rosa et al (2019) included subjective assessment of device insertion when evaluating an LMA with a tracheal cannula in general anesthesia conditions (23).…”

Section: Discussionmentioning

confidence: 99%

A Survey of Provider Satisfaction of a New, Flexible Extended-Length Pharyngeal Airway to Relieve Upper Airway Obstruction During Deep Sedation

McMurray

2020

Preprint

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BackgroundMaintaining an open airway in a spontaneously-breathing patient under deep sedation, or deep monitored anaesthesia care, can be challenging. Specifically, current oral airways are not long enough to displace obstruction caused by redundant pharyngeal tissue, prompting external maneuvers by anesthetists that can impact patient outcomes and facility operational efficiency. As procedures increase at outpatient surgical centers, there is a need for an anesthesia provider-validated airway device that can sufficiently open an obstructed airway and maintain airway patency.MethodsThis prospective, multi-center user-experience survey evaluated anesthesia provider experience of a new airway device for adult patients with airway obstruction during deep sedation. The novel external airway has a longer flexible tubing allowing for displacement of pharyngeal tissue, smaller diameter to allow placement alongside an endoscopy bite block, and is manufactured with softer material to allow ease of insertion and patient comfort.ResultsFifty-four anaesthetists at 15 hospital systems reported their experience of airway use in 86 cases. The novel airway device was 95% successful in establishing and maintaining a patent airway (n=68). Survey responses indicated that the airway was easy to place (93%), allowed for a “hands-off approach” (98%), and would improve airway management practice and patient outcomes (86%).ConclusionsThis pilot study demonstrated that the novel external airway is an effective and satisfactory method for anaesthesia providers to alleviate airway obstruction during deep sedation. Additional studies will be initiated to confirm efficacy and cost-effectiveness in patient populations and clinical environments that will most benefit from the new airway device.

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Laryngeal Mask Airway Supreme vs. the Spritztube tracheal cannula in anaesthetised adult patients

Cited by 8 publications

References 16 publications

Emergency treatment of airway obstruction caused by a laryngeal neuroendocrine tumor: A case report

Emergency treatment of airway obstruction caused by a laryngeal neuroendocrine tumor: A case report

Size selection of the Ambu AuraOnce laryngeal mask in Chinese men weighing >70 kg: a pilot study

A Survey of Provider Satisfaction of a New, Flexible Extended-Length Pharyngeal Airway to Relieve Upper Airway Obstruction During Deep Sedation

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