Pre-selection of primary intubation technique is associated with a low incidence of difficult intubation in patients with a BMI of 35 kg/m2 or higher

Ezri, Tiberiu; Waintrob, Ronen; Avelansky, Yuri; Izakson, Alexander; Dayan, Katia; Shimonov, Mordechai

doi:10.21454/rjaic.7518.251.ezr

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…Additional advantages of SGA use include the reduced incidence of laryngospasm on emergence and reversible bronchospasm [11]. SGAs play a vital role in the ASA practice guidelines for difficult airway management [12][13][14][15][16]. Although contraindicated in situations involving elevated risk of regurgitation, SGA use is still appropriate in emergent airway scenarios [17].…”

Section: Discussionmentioning

confidence: 99%

Safety, Efficacy, and Ease of Insertion of Gnana Laryngeal Airway (GLA-4): A Prospective Clinical Study Utilizing the Unique Laryngeal Mask Airway With a Suction Tubing

Ahmadzadeh,

Singh,

Sharpe

et al. 2023

Cureus

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Introduction: Utilizing laryngeal mask airways to maintain patients' airways is advantageous because it enables the anesthesiologist to keep the patient spontaneously inhaling and is less traumatic to the airway than intubation. Newer designs such as the Gnana laryngeal mask airway design permit real-time suctioning while the mask is on a patient. Methods: This is a prospective observational study of the efficacy of Gnana laryngeal airway 4 (GLA-4) in 50 patients undergoing colonoscopy. Induction and maintenance of anesthesia were provided with propofol; GLA-4 was applied to secure the airway; and correct placement was verified.Results: Fifty patients were included in the study (44% female, 56% male, mean age: 56.5 years, mean BMI: 33.3). Twelve patients were assigned American Society of Anesthesiologists (ASA) class 2, and 38 were assigned ASA class 3. The first attempt of GLA-4 insertion was successful in 47 patients, and two attempts were required for the successful placement of the GLA-4 in two patients. The successful placement was not achieved in one patient. The average time to successful insertion was 27.1 ± 3.9s. The average volume of oropharyngeal secretions suctioned through the suction catheter was 9.96 ± 2.31 mL. No intraoperative or postoperative complications occurred in the 50 patients. There were no reports of sore throat, hoarseness, dysphagia, or cough immediately postop.Conclusion: GLA-4 can be inserted safely with adequate periglottic occlusion. This laryngeal mask is unique and desirable due to its ability to evacuate oropharyngeal secretions while in place to prevent laryngospasm. To establish the role of GLA-4 in broader clinical situations, additional clinical trials and studies are required.

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Section: Discussionmentioning

confidence: 99%

Safety, Efficacy, and Ease of Insertion of Gnana Laryngeal Airway (GLA-4): A Prospective Clinical Study Utilizing the Unique Laryngeal Mask Airway With a Suction Tubing

Ahmadzadeh,

Singh,

Sharpe

et al. 2023

Cureus

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“…[ 41 42 ] Preselecting special airway techniques such as VL or fiberoptic intubation (FOI) to use for the initial intubation attempt in patients with a predicted high risk of DI is associated with a lower incidence of DI than what is typically reported in patients with a BMI ≥35 kg/m 2 or higher. [ 43 ] In a prospective randomized study conducted by Castillo-Monzon et al ., comparing the DL and VL, the VL yielded more frequent easy airway visualization in the morbidly obese as assessed by a modified Cormack-Lehane classification and needed fewer optimization maneuvers for tracheal intubation. Despite these slight advantages, no statistically significant difference in the duration or success of intubation was found between the use of either the VL or DL.…”

Section: Literature Reviewmentioning

confidence: 99%

Airway management in patients with obesity

Moon

Thota

Jan

et al. 2022

Saudi Journal of Anaesthesia

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Airway management in patients with obesity remains a complex and evolving topic that is becoming more pertinent given the increasing prevalence of obesity and bariatric surgery worldwide. Obesity is associated with increased morbidity and mortality secondary to anesthetic complications, especially related to airway management. Preoperative assessment is especially vital for the bariatric patient so that potential predictors for a difficult airway can be identified. There are several airway management strategies and techniques for the bariatric population that may help reduce postoperative pulmonary complications. This review aims to discuss assessment of the airway, ideal patient positioning, intubation techniques and devices, apneic oxygenation, optimal ventilation strategies, and extubation and post-anesthesia care.

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La videolaringoscopia es una alternativa segura en el paciente despierto con vía aérea difícil anticipada. Reporte de Caso

Jiménez-Orduz,

Camelo-Pardo,

Archila-Tibaduiza

et al. 2022

MedUNAB

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Introducción. El manejo de la vía aérea difícil anticipada es un reto anestésico que supone la valoración preoperatoria de las características anatómicas y los factores de riesgo específicos del paciente. La intubación difícil se presenta en 1.6 de 1,000 eventos y la intubación fallida en 0.06 de 1,000 eventos. El objetivo de este reporte es mostrar la importancia del uso de dispositivos (específicamente videolaringoscopio) en pacientes con predicción de vía aérea difícil. Presentación del caso. Hombre de 63 años con gran masa facial con extensión a nariz, labio superior, erosión a nivel del maxilar superior que ocupaba cavidad oral, con predictores de ventilación e intubación difícil, programado para rinectomía, osteotomía Lefort II, reconstrucción y traqueostomía, con intubación exitosa con videolaringoscopio en primer intento bajo sedación consciente y ventilación espontánea. Discusión. La vía aérea difícil es un escenario relacionado a factores externos e internos del paciente y a complicaciones pre e intraoperatorias. El videolaringoscopio es una herramienta útil que permite la intubación exitosa y disminuye los posibles eventos adversos (como se observó en el paciente del caso presentado) y es descrito en diferentes reportes de casos con compromiso parcial o total de la vía aérea. Conclusión. La videolaringoscopia, en casos de vía aérea difícil anticipada, está asociada con un menor tiempo de intubación, un buen perfil de seguridad y una alta tasa de éxito, comparable a la del fibrobroncoscopio, se logra la intubación en el primer intento en la mayoría de las veces y, por ello, debería considerarse como primera opción.

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Pre-selection of primary intubation technique is associated with a low incidence of difficult intubation in patients with a BMI of 35 kg/m2 or higher

Abstract: The lower incidence of DI in our study group may stem from the primary use of special intubation devices, based on the presence of predictors of DI.

Cited by 3 publications

References 24 publications

Safety, Efficacy, and Ease of Insertion of Gnana Laryngeal Airway (GLA-4): A Prospective Clinical Study Utilizing the Unique Laryngeal Mask Airway With a Suction Tubing

Safety, Efficacy, and Ease of Insertion of Gnana Laryngeal Airway (GLA-4): A Prospective Clinical Study Utilizing the Unique Laryngeal Mask Airway With a Suction Tubing

Airway management in patients with obesity

La videolaringoscopia es una alternativa segura en el paciente despierto con vía aérea difícil anticipada. Reporte de Caso

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