Use of the Laryngeal Mask Airway as an Alternative to the Tracheal Tube During Ambulatory Anesthesia

Joshi, Girish P.; Inagaki, Yoshimi; White, Paul F.; Taylor-Kennedy, Lisa; Wat, Linda I.; Gevirtz, Clifford; McCraney, John M.; McCulloch, D.

doi:10.1097/00000539-199709000-00016

Cited by 87 publications

(55 citation statements)

References 15 publications

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“…[3] The incidence to post-operative sore throat and hoarseness is also lower with supraglottic devices. [45] The search is on for supraglottic airway device which combines the advantages of supraglottic airway devices and also provide effective protection against aspiration. The i-gel (Intersurgical Ltd, Wokingham, UK) is a novel supraglottic airway device (SAD).…”

Section: Introductionmentioning

confidence: 99%

To assess the efficacy of i-gel for ventilation, blind tracheal intubation and nasogastric tube insertion

et al. 2013

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Background:The i-gel is a novel supraglottic airway device with a soft and non-inflatable cuff. In our study we attempted to evaluate the performance of i-gel as a ventilatory device, as a conduit to blind tracheal intubation using conventional polyvinyl chloride tracheal tube and gastric tube insertion through it.Materials and Methods:A total of 180 patients of American Society of Anesthesiologist (ASA) physical status I/II undergoing elective surgery under general anesthesia were included in this study. After induction of anesthesia, i-gel was inserted and the following parameters were recorded: Time taken for successful i-gel insertion, airway leak pressures, ease of gastric tube insertion and laryngeal view using fiberscope. Following this blind tracheal intubation was attempted. First attempt and overall success rate in blind tracheal intubation and gastric tube insertion were evaluated and tracheal intubation time was measured. Also presence of any side effects or complication following removal was recorded.Results:We achieved a 100% success rate in insertion of i-gel and in 171 out of 180 patients; i-gel was inserted in the 1st attempt itself. We also were able to achieve an overall success rate for blind endotracheal intubation via i-gel in 78.33% cases, and successful gastric tube placement was possible in 92.22%. In our study we also achieved a leak pressure of 25.52 (±2.33) cm of H2O.Conclusion:I-gel may be effectively used for ventilation, nasogastric tube insertion and as a conduit to blind endotracheal intubation with minimal complication and acceptable airway sealing pressures.

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Section: Introductionmentioning

confidence: 99%

To assess the efficacy of i-gel for ventilation, blind tracheal intubation and nasogastric tube insertion

et al. 2013

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“…Invented in 1983, the LM has become a major tool of airway management in almost all surgical fields. For many surgical procedures, especially those of short duration and a low complication profile, an LM has become the airway management of choice . There is a broad acceptance of the LM in nonotolaryngological settings, with a lot of studies showing equal if not fewer complications while also shortening the duration needed for anesthesia .…”

Section: Discussionmentioning

confidence: 99%

Laryngeal mask versus intubation for adenoidectomies in children: Analysis of 1,500 operations

et al. 2019

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Objectives/Hypothesis: To evaluate whether endotracheal intubations are superior to the use of laryngeal masks in the airway management for adenoidectomies in pediatric patients in terms of safety and duration of surgery.Study Design: Retrospective case series. Methods: A retrospective analysis of 1,500 adenoidectomies in children using laryngeal mask or endotracheal intubation for intraoperative ventilation between 2009 and 2017. Data collected included complications, duration of surgery, and duration of induction and emergence from anesthesia.Results: The use of laryngeal masks did not accelerate the time needed for induction and emergence of anesthesia although significantly increasing the duration of surgery itself. There also were significantly more complications during and after anesthesia when using a laryngeal mask. In 10% of the children, the laryngeal mask had to be replaced by an endotracheal tube intraoperatively.Conclusions: There is no reason to recommend the use of a laryngeal mask as the first choice of airway management regarding adenoidectomies in children.

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“…Stated advantages with respect to tracheal intubation include efficiency, the absence of need to use muscle relaxants and improved recovery profile. [56] Different modes of ventilation used with LMA in general anesthesia has been studied and compared,[71112] but no one had investigated the use of PC-VG.…”

Section: Discussionmentioning

confidence: 99%

“…[34] It has been successfully used as an alternative to the endotracheal tube in general anesthesia of short procedures with spontaneous or assisted ventilation. [56]…”

Section: Introductionmentioning

confidence: 99%

Ventilation of nonparalyzed patients under anesthesia with laryngeal mask airway, comparison of three modes of ventilation: Volume controlled ventilation, pressure controlled ventilation, and pressure controlled ventilation-volume guarantee

et al. 2017

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Background:Pressure controlled ventilation (PCV) is the preferable mode of ventilation of nonparalyzed patients undergoing anesthesia with laryngeal mask airway (LMA) as compared to volume controlled ventilation (VCV) and spontaneously breathing patient. In this study, we compared the PC–volume guarantee (PC-VG) mode of ventilation with VCV and PCV modes.Materials and Methods:A total of 30 patients, American Society of Anesthesiologists (ASA) physical status Classes I and II, scheduled for elective surgery under general anesthesia with a classic LMA were ventilated, subsequently, with the three modes of ventilation: VCV, PCV, and PC-VG for 10 min each mode. Tidal volume set for all patients was 8 ml/kg of ideal body weight. Parameters measured with modes of ventilation include peak inspiratory pressure (PIP), compliance, measured tidal volume, O2 saturation, end-tidal CO2, and presence of an oropharyngeal leak.Results:The PIP was significantly higher with the application of VCV mode of ventilation than PCV and PC-VG modes. The compliance was significantly lower when using the mode of ventilation VCV than PCV and PC-VG. The PIP and the compliance were not statistically different between the PCV and PC-VG modes of ventilation.Conclusions:Ventilation of nonparalyzed patients with LMA under anesthesia with PC-VG is advantageous over VCV in reducing PIP and increasing lung compliance. No difference was noted between PCV and PC-VG in ASA Classes I or II under the adequate depth of anesthesia in patients with normal pulmonary function.

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Use of the Laryngeal Mask Airway as an Alternative to the Tracheal Tube During Ambulatory Anesthesia

Abstract: Use of the laryngeal mask airway can obviate the need for insertion of a tracheal tube for many ambulatory surgery procedures, and thereby decrease the incidence of postoperative sore throats.

Cited by 87 publications

References 15 publications

To assess the efficacy of i-gel for ventilation, blind tracheal intubation and nasogastric tube insertion

To assess the efficacy of i-gel for ventilation, blind tracheal intubation and nasogastric tube insertion

Laryngeal mask versus intubation for adenoidectomies in children: Analysis of 1,500 operations

Ventilation of nonparalyzed patients under anesthesia with laryngeal mask airway, comparison of three modes of ventilation: Volume controlled ventilation, pressure controlled ventilation, and pressure controlled ventilation-volume guarantee

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