Low-flow and minimal-flow anaesthesia using the laryngeal mask airway

Möllhoff, T.; Burgard, G.; Prien, T.

doi:10.1046/j.1365-2346.1996.00988.x

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…Möllhoff et al . in 1996[ 16 ] used LMA during low and minimal –flow anesthesia in patients undergoing short elective gynecological surgery. There was no ETT- control group in this study.…”

Section: Discussionmentioning

confidence: 99%

Low flow anesthesia: Efficacy and outcome of laryngeal mask airway versus pressure-optimized cuffed-endotracheal tube

et al. 2010

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BackgroundLow flow anesthesia can lead to reduction of anesthetic gas and vapor consumption. Laryngeal mask airway (LMA) has proved to be an effective and safe airway device. The aim of this study is to assess the feasibility of laryngeal mask airway during controlled ventilation using low fresh gas flow (1.0 L/min) as compared to endotracheal tube (ETT).Patients and MethodsFifty nine non-smoking adult patients; ASA I or II, being scheduled for elective surgical procedures, with an expected duration of anesthesia 60 minutes or more, were randomly allocated into two groups - Group I (29 patients) had been ventilated using LMA size 4 for females and 5 for males respectively; and Group II (30 patients) were intubated using ETT. After 10 minutes of high fresh gas flow, the flow was reduced to 1 L/min. Patients were monitored for airway leakage, end-tidal CO2(ETCO2), inspiratory and expiratory isoflurane and nitrous oxide fraction concentrations, and postoperative airway-related complications.ResultsTwo patients in the LMA-group developed initial airway leakage (6.9%) versus no patient in ETT-group. Cough and sore throat were significantly higher in ETT patients. There were no evidences of differences between both groups regarding ETCO2, uptake of gases, nor difficulty in swallowing.Conclusion:The laryngeal mask airway proved to be effective and safe in establishing an airtight seal during controlled ventilation under low fresh gas flow of 1 L/min, inducing less coughing and sore throat during the immediate postoperative period than did the ETT, with continuous measurement and readjustment of the tube cuff pressure.

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Section: Discussionmentioning

confidence: 99%

Low flow anesthesia: Efficacy and outcome of laryngeal mask airway versus pressure-optimized cuffed-endotracheal tube

et al. 2010

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“…19 Use of SAD during low and minimal flow anesthesia with controlled ventilation has been shown by others to be safe in Trendelenburg position. 1,4,20 The airway seal of I-gel has been found to be adequate with chest compressions during cardiopulmonary resuscitation and as a result, an I-gel resuscitation pack has been introduced. 21,22 We did not find any clinical or volumetric evidence of a leak in surgeries done in Trendelenburg position.…”

Section: Discussionmentioning

confidence: 99%

“…The use of SAD to deliver low flow and minimal flow anesthesia has been restricted to anesthesiologists experienced with their use and with the use of minimal flow anesthesia. 4 This study was formulated to show the safety and efficacy of I-gel (Intersurgical Ltd, Berkshire, UK) use during minimal flow anesthesia with volume controlled ventilation (VCV) for laparoscopic surgery of < 2 h duration.…”

Section: Introductionmentioning

confidence: 99%

I-gel supraglottic airway use is efficient and safe during minimal flow anesthesia with volume controlled ventilation - a randomized controlled trial

Khan

Kapoor

Garg

et al. 2020

APIC

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Background: A fear of potential gas leak limits the wide spread use of minimal flow anesthesia with supraglottic airway devices. Second generation supraglottic airway devices have been claimed to be come with good airway seal. I-gel is one of these and it has been extensively evaluated for spontaneous as well as assisted ventilation. We conducted this study to evaluate its use with low flow anesthesia and volume controlled ventilation. Methodology: In a prospective randomized controlled trial, 50 patients undergoing laparoscopic surgeries for less than 2 h duration were administered general anesthesia, with controlled ventilation, using either endotracheal tube or an I-gel for airway control. The total fresh gas flow was gradually reduced until it was 400 mL/min. Patients were monitored for evidence of loss of respiratory gas volume in the breathing circuit and other parameters for ventilation failure. Results: Ventilation could be maintained at a fresh gas flow of 400 mL/min, without clinical or volumetric evidence of gas leak in all patients in the two groups. Two patients in the I-gel group had intraoperative gas leak leading to ventilator failure alarm but the same was corrected by repositioning of the head. The vital signs, peak airway pressure, end-tidal carbon dioxide, set tidal volume and expired tidal volumes were statistically similar in the two groups. Conclusion: I-gel supraglottic airway can be safely and efficiently used for laparoscopic surgery using minimal flow anesthesia and volume controlled ventilation. Citation: Khan A, Kapoor MC, Garg S, Puri A, Sinha A. I-gel supraglottic airway use is efficient and safe during minimal flow anesthesia with volume controlled ventilation - a randomized controlled trial. Anaesth pain intensive care 2020;24(1):__ Abbreviations: Supraglottic airway device – SAD; Volume controlled ventilation – VCV; Pressure controlled ventilation – PCV; Endotracheal tube – ETT; Laryngeal Mask Airway - LMA DOI: https://doi.org/10.35975/apic.v24i1. Received – 11 June 2019; Reviewed – 20, 23 October 2019; Revised – 31 January 2020; Second Review – 2, 7 January 2020; Accepted – 02 February 2020;

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“…8,9 According to some studies the use of laryngeal mask airway is safer when a low flow anesthesia is utilized. 10,11 As with any intervention procedure the use of LMA or ETT also have its fair share of complications, the incidence of sore throat post operatively is reported to be higher with the use of ETT than Laryngeal mask airway, while complications such as hoarseness, bleeding and injury to the nerves and surrounding structures is more reported with LMA. 12, 13,14,15 The complication with the use of airways can be explained by the use of a high pressure cuff with nitrogen oxide gas during the maintenance anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Low Flow Anesthesia

Raza

Bourazza

Kamlaish

2016

TPMJ

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Objectives: The aim of our study is to determine the incidence of complicationswhen using Laryngeal mask airway and compare it with endotracheal tube intubation, duringadministration of low flow anesthesia. Study Design: A randomized control trial. Period: 3months from February 2015 to April 2015. Setting: Tertiary Care Hospital in Karachi Pakistan.Materials and Methods: The study population consisted of n= 100 patients who underwentelective operative procedures of the eye. Patients who belonged to the ASA classification typeI and II were allocated into two groups using a random number generator. Group A consistedof all the patients on whom endotracheal tube was used as airway and group B included all thepatients on whom Laryngeal mask airway was used. The complications were noted on a predesignedproforma. Data was analyzed using SPSS version 23. Results: The study populationconsisted of n= 100 patients out of which n= 43 were males and n= 57 were females, 42%of the patients belonged to ASA classification I and 58% belonged to the ASA classificationII. Leakage of air was observed in 7% of the patients, postoperative shivering was observedin 20%, sore throat was observed in n= 22 patients, of which n= 18 patients belonged to theETT group and n= 4 patients belonged to the LMA group. Endotracheal carbon dioxide levelsdid not show any significant difference. Conclusion: According to the results of our study,Laryngeal mask airway has a lower incidence of post-operative complications, provided that itspositioning and cuff pressure are noted and maintained regularly, and it can be used as a safealternative to endotracheal intubation when using low flow controlled anesthesia respectively.

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Low-flow and minimal-flow anaesthesia using the laryngeal mask airway

Cited by 6 publications

References 24 publications

Low flow anesthesia: Efficacy and outcome of laryngeal mask airway versus pressure-optimized cuffed-endotracheal tube

Low flow anesthesia: Efficacy and outcome of laryngeal mask airway versus pressure-optimized cuffed-endotracheal tube

I-gel supraglottic airway use is efficient and safe during minimal flow anesthesia with volume controlled ventilation - a randomized controlled trial

Low Flow Anesthesia

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