Use of a modified Magill's forceps to place a flexible laryngeal mask

Welsh, B.E.

doi:10.1111/j.1365-2044.1995.tb05897.x

Cited by 16 publications

(8 citation statements)

References 4 publications

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“…The possible explanation is the FLMA itself has a longer, narrower, non-rigid flexometallic tube that differs from that used with the LMA. The force cannot be transmitted along the shaft, which makes it more difficult to insert [ 20 , 21 ]. This variable incidence of difficulties can be explained by both differences in defining a difficult insertion and the variety of insertion techniques used by anesthesiologists with different levels of experience.…”

Section: Discussionmentioning

confidence: 99%

Airway Complications during and after General Anesthesia: A Comparison, Systematic Review and Meta-Analysis of Using Flexible Laryngeal Mask Airways and Endotracheal Tubes

Lian

2016

PLoS ONE

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ObjectiveFlexible laryngeal mask airways (FLMAs) have been widely used in thyroidectomy as well as cleft palate, nasal, upper chest, head and neck oncoplastic surgeries. This systematic review aims to compare the incidence of airway complications that occur during and after general anesthesia when using the FLMA and endotracheal intubation (ETT). We performed a quantitative meta-analysis of the results of randomized trials.MethodsA comprehensive search of the PubMed, Embase and Cochrane Library databases was conducted using the key words "flexible laryngeal mask airway" and "endotracheal intubation". Only prospective randomized controlled trials (RCTs) that compared the FLMA and ETT were included. The relative risks (RRs) and the corresponding 95% confidence intervals (95% CIs) were calculated using a quality effects model in MetaXL 1.3 software to analyze the outcome data.ResultsTen RCTs were included in this meta-analysis. There were no significant differences between the FLMA and ETT groups in the incidence of difficulty in positioning the airway [RR = 1.75, 95% CI = (0.70–4.40)]; the occurrence of sore throat at one hour and 24 hours postoperative [RR = 0.90, 95% CI = (0.13–6.18) and RR = 0.95, 95% CI = (0.81–1.13), respectively]; laryngospasms [RR = 0.58, 95% CI = (0.27–1.23)]; airway displacement [RR = 2.88, 95% CI = (0.58–14.33)]; aspiration [RR = 0.76, 95% CI = (0.06–8.88)]; or laryngotracheal soiling [RR = 0.34, 95% CI = (0.10–1.06)]. Patients treated with the FLMA had a lower incidence of hoarseness [RR = 0.31, 95% CI = (0.15–0.62)]; coughing [RR = 0.28, 95% CI = (0.15–0.51)] during recovery in the postanesthesia care unit (PACU); and oxygen desaturation [RR = 0.43, 95% CI = (0.26–0.72)] than did patients treated with ETT. However, the incidence of partial upper airway obstruction in FLMA patients was significantly greater than it was for ETT patients [RR = 4.01, 95% CI = (1.44–11.18)].ConclusionThis systematic review showed that the FLMA has some advantages over ETT because it results in a lower incidence of hoarseness, coughing and oxygen desaturation. There were no statistically significant differences in the difficulty of intubation or in the occurrence of laryngospasms, postoperative sore throat, airway displacement, aspiration or laryngotracheal soiling. However, there was a higher incidence of partial upper airway obstruction in the FLMA than in the ETT group. We conclude that the FLMA has some advantages over ETT, but surgeons and anesthesiologists should be cautious when applying the mouth gag, moving the head and neck, or performing oropharyngeal procedures to avoid partial upper airway obstruction and airway displacement. The FLMA should not be used on patients at high risk for aspiration.

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Section: Discussionmentioning

confidence: 99%

Airway Complications during and after General Anesthesia: A Comparison, Systematic Review and Meta-Analysis of Using Flexible Laryngeal Mask Airways and Endotracheal Tubes

Lian

2016

PLoS ONE

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“…Neben Verfahren, die LMA mit einem teilweise belüfteten Cuff [4 ± 6] und/oder in rotierender Weise [7 ± 9] oder auch entlang der Zungenpapillen vorzuführen [10], wurden Einführhilfen vorgeschlagen wie Plastiklöffel [11], Gaumenschützer [12 ± 14], Metallzangen [15,16], Führungsstäbe [17 ± 20] und eine Kunststoffversteifung [21], in die die flexible LMA eingespannt wird. Eine überzeugende und verbreitete Lösung ist daraus nicht erwachsen.…”

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Die Platzierung von flexiblen Larynxmasken (LMA) mit der „Einführhilfe nach Zerer”

Ehrensperger¹,

Gross²,

Zerer³

et al. 2004

Anästhesiol Intensivmed Notfallmed Schmerzther

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“…These are classified into two categories: outer and inner devices. The outer devices (standard Magill forceps [1], Bosworth introducer [2]) have potential disadvantages of causing trauma and occupying the oral space. The inner devices (metal stylet, small tracheal tube [3], combined metal stylet and tracheal tube [4]) also have some problems.…”

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confidence: 99%