Lightwand-Guided Insertion of Flexible Reinforced Laryngeal Mask Airway: Comparison with Standard Digital Manipulation Insertion

Kim, Dae–Hee; Chae, Yun Jeong; Min, Sung Kil; Ha, Eun Ji; Yoo, Ji Young

doi:10.12659/msm.928538

Cited by 3 publications

(6 citation statements)

References 32 publications

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“…In the current study, the OLP was comparable in the two groups with no significant difference ( p =0.674). The result is consistent with that of Kim et al ( 13 ). Our findings showed an ideal RLMA placement (Fiberoptic score of 3&4) in 88.7% of the tongue depressor group vs. 67% in the standard group.…”

Section: Discussionsupporting

confidence: 94%

“…Other options described by some authors are the use of a spatula, Bosworth introducers and Flexiguide introducer to facilitate insertion ( 11 ). Kulkarni et al designed an acrylic sheath ( 12 ) while Kim et al ( 13 ) used light wand-guided insertion of the device. All the methods are useful for placement but they are either time-consuming or require preparation and adjustmen( 14 ).…”

Section: Introductionmentioning

confidence: 99%

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Wooden Disposable Tongue Depressor: Can Facilitate Appropriate Reinforced Laryngeal Mask Insertion? A Randomized Controlled Trial

Salman

Al-Asadi

2022

Med. J. Islam. Republ. Iran

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Background: The reinforced laryngeal mask airway (RLMA) is difficult to insert due to the flexibility of its inner armored shaft. Many authors agreed that the available techniques have some disadvantages. They use materials that are reusable and require resterilization but may not guarantee infection control particularly during pandemics. The standard method can cause contamination and prone the operator to unanticipated trauma to their finger during placement. So this study aimed to evaluate the usefulness of disposable tongue depressors to aid insertion of the reinforced laryngeal mask airway. Methods: A randomized controlled trial included one hundred ninety-four adult patients of either gender American Society of Anesthesiologists (ASA) I and II attended for elective day case surgery under general anesthesia. Patients were randomly categorized into two groups; each group consisted of ninety-seven. In the first group, insertion of the reinforced laryngeal mask airway was done using the standard technique of digital manipulation whereas the second one is the study group where disposable wooden tongue depressor guided insertion was used. The data were analyzed using SPSS version 23. Data were presented as frequencies or means and standard deviations. Chi-Square, Fisher Exact, and t-test were used. P value < 0.05 was considered significant. Results: No significant difference in basic patients' demographic, anthropometric, and clinical characteristics were noticed between the two groups. The insertion time as well as the total time for RLMA placement, was significantly shorter in the new method group. Trauma was significantly less than 2.1% in the new method group compared to the standard group 10.3%, p =0.003). Conclusion: The disposable wood tongue depressor insertion technique helps facilitate the correct placement of the reinforced laryngeal mask airway.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Wooden Disposable Tongue Depressor: Can Facilitate Appropriate Reinforced Laryngeal Mask Insertion? A Randomized Controlled Trial

Salman

Al-Asadi

2022

Med. J. Islam. Republ. Iran

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“…[ 4 5 ] The advancement in anaesthesia practice is towards securing airway devices under vision rather than inserting them blindly, for which several techniques and devices such as laryngoscopes, lightwand, C-MAC videolaryngoscope and other videolaryngoscopeshave been used. [ 6 9 11 12 13 14 15 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 18 ] Several studies have reported the effectiveness of under-vision-guided insertion techniques of SGA devices in terms of attaining higher OPLPs. [ 6 9 11 12 ] Kim et al . [ 9 ] in their study, reported higher OPLPs when LMA (LarySeal™ ) was inserted under laryngoscope guidance (21 ± 8.6 cm of H 2 O) when compared to blind insertion technique (18.1 ± 6.1 cm of H 2 O).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy of Macintosh laryngoscope-guided insertion of I-gel™ with the conventional blind insertion technique – A randomised study

Vyas¹,

Bihani²,

Jaju³

et al. 2022

Indian Journal of Anaesthesia

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Background and Aims: This study was designed to compare the efficacy of Macintosh laryngoscope-guided insertion of I-gel™ with the conventional blind insertion technique. Methods: A total of 156 adult patients scheduled to undergo elective surgery under general anaesthesia were included. All participants were randomly divided into two groups; I-gel™ was inserted with conventional blind and Macintosh laryngoscopic-guided technique in group A and B respectively. The primary objective of the study was to determine the incidence of optimal positioning in both the groups based on fibreoptic bronchoscope score of the glottic view. Oropharyngeal leak pressure, haemodynamic parameters and insertion characteristics were also compared. Categorical data were presented as ratio or percentage, continuous data were presented as mean ± standard deviation or median (95% confidence interval). The strength of association between insertion technique and the anatomical fit of the device was calculated by relative risk ratio. Results: Fibreoptic scores were significantly better in laryngoscope-guided insertion group when compared to the blind insertion group ( P < 0.0001). The incidence of malposition was 3.85% in the laryngoscopic insertion group and 39.4% in the blind insertion ( P < 0.0001). Oropharyngeal leak pressure was higher in laryngoscope-guided insertion group than in blind insertion group (26.89 ± 3.37 cm H 2 O versus 24.42 ± 3.00 cm H 2 O; P < 0.0001). Other insertion characteristics except time taken to insert the device were comparable in both groups. Conclusion: When compared to the standard blind insertion technique, laryngoscope-guided insertion of I-gel™ results in better alignment with the laryngeal inlet providing a proper anatomical fit and better airway seal pressure.

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“…Various techniques have been investigated to increase the success rate of SGA device insertion in the first attempt, including the 90° rotation technique, 180° rotation technique, head elevation, or rotation and guidance technique [7][8][9][10][11][12]. Among these approaches, the 90° rotation technique was first introduced by Hwang et al in 2009 [7].…”

Section: Introductionmentioning

confidence: 99%

Standard digit-based versus 90° rotation technique for supraglottic airway device insertion: a meta-analysis of randomized controlled trials

Koo

Jeon

et al. 2022

Korean J Anesthesiol

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Background: Prompt insertion and placement of the supraglottic airway (SGA) devices in the correct position are required to secure the airway. This meta-analysis was performed to validate the usefulness of the 90° rotation technique as compared with the standard digit-based technique for the insertion of SGA devices in anesthetized patients in terms of success rate, insertion time, and postoperative complications.Methods: A literature search of PubMed, EMBASE, CENTRAL, CINAHL, Scopus, and Web of Science was conducted. Randomized controlled trials, without limitations on publication period, language, journal, or region, until July 2021, that compared the 90° rotation and the standard digitbased techniques for insertion of SGA devices in anesthetized patients were included. Results:The first-attempt (risk ratio [RR] 1.16, 95% confidence interval [CI] 1.09 to 1.25, p < 0.001) and overall success rates (RR 1.06, 95% CI 1.03 to 1.09, p < 0.001) were significantly higher in the 90° rotation group. The insertion time was shorter in the 90° rotation group (mean difference -4.42 s, 95% CI -6.90 s to -2.15 s, p < 0.001). The incidences of postoperative sore throat (OR 0.63, 95% CI 0.49 to 0.83, p < 0.001) and blood staining (RR 0.28, 95% CI 0.20 to 0.39, p < 0.001) were lower in the 90° rotation group. Conclusions:The use of the 90° rotation technique increases the success rate of SGA device insertion and decreases pharyngeal mucosal trauma as compared with that of the standard digit-based technique in anesthetized patients.

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Lightwand-Guided Insertion of Flexible Reinforced Laryngeal Mask Airway: Comparison with Standard Digital Manipulation Insertion

Cited by 3 publications

References 32 publications

Wooden Disposable Tongue Depressor: Can Facilitate Appropriate Reinforced Laryngeal Mask Insertion? A Randomized Controlled Trial

Wooden Disposable Tongue Depressor: Can Facilitate Appropriate Reinforced Laryngeal Mask Insertion? A Randomized Controlled Trial

Comparison of the efficacy of Macintosh laryngoscope-guided insertion of I-gel™ with the conventional blind insertion technique – A randomised study

Standard digit-based versus 90° rotation technique for supraglottic airway device insertion: a meta-analysis of randomized controlled trials

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