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Oropharyngeal Leak Pressure (oropharyngeal + leak_pressure)
Selected AbstractsThe ProSealTM laryngeal mask airway in childrenPEDIATRIC ANESTHESIA, Issue 3 2005M. LOPEZ-GIL MD Summary Background :,The ProSealTM (PLMA) is a new laryngeal mask device with a modified cuff to improve the seal and a drain tube to provide access to the gastrointestinal tract. We assessed the performance of the size 2 (which has no dorsal cuff) and size 3 (which has a dorsal cuff) in terms of insertion success, efficacy of seal, tidal volume, gas exchange, fiberoptic position, gastric tube placement and frequency of problems. Methods :,Eighty children undergoing minor surgery were studied (n = 40, size 2 PLMA, weight 10,25 kg; n = 40, size 3 PLMA, weight >25,50 kg). Induction was with remifentanil and propofol. Insertion was with the introducer tool and by experienced users. Maintenance was with propofol or sevoflurane and pressure controlled ventilation. Results :,The first-time and overall insertion success rate was 84 and 100%, respectively. Oropharyngeal leak pressure was 31 ± 5 cmH2O. There were no gastric or drain tube air leaks. Tidal volume and gas exchange was adequate in all patients, other than two brief episodes of hypoxia because of airway reflex activation. The vocal cords and epiglottis were visible in 99 and 80%, respectively, via the airway tube. The first-time and overall insertion success rate for gastric tube insertion was 87 and 100%, respectively. During maintenance, the PLMA was removed in one patient with airway reflex activation and another required epinephrine for bronchospasm. There were no differences in performance between the sizes 2 and 3 PLMA. Conclusion :,The PLMA is an effective airway device in children and isolates the glottis from the esophagus when correctly positioned. Despite the lack of a dorsal cuff, the performance of the size 2 was similar to the size 3 PLMA in the age groups tested. [source] Insertion and use of the LMA SupremeÔ in the prone position,ANAESTHESIA, Issue 2 2010A. M. López Summary We investigated whether insertion of an LMA SupremeÔ and its use for maintenance of anaesthesia is feasible in the prone position. Forty adult patients positioned themselves prone and were given propofol until the Bispectral Index was < 50. A size-4 LMA Supreme was inserted by experienced anaesthetists. Ease of insertion, ease of ventilation, efficacy of seal, ease of gastric tube insertion, blood staining, postoperative sore throat, and other complications were recorded. Insertion was successful at the first and second attempt in 37 (92.5%) and 3 (7.5%) patients, respectively. The mean (SD) insertion time was 21 (15) s. Oropharyngeal leak pressure was greater in females than males (29 (4) vs 25 (4) cmH2O, respectively, p = 0.01). Adequate ventilation was achieved in all patients. Gastric tube placement was successful in all patients. The frequency of blood staining and sore throat was 7.5% each. No other complications were noted. We conclude that use of the LMA Supreme in the prone position by experienced users is feasible. [source] The Laryngeal Mask Airway SupremeTM, a single use laryngeal mask airway with an oesophageal vent.ANAESTHESIA, Issue 1 2009A randomised, anaesthetised patients, cross-over study with the Laryngeal Mask Airway ProSealTM in paralysed Summary The LMA SupremeTM is a new extraglottic airway device which brings together features of the LMA ProSealTM, FastrachTM and UniqueTM. We test the hypothesis that ease of insertion, oropharyngeal leak pressure, fibreoptic position and ease of gastric tube placement differ between the LMA ProSealTM and the LMA SupremeTM in paralysed anesthetised patients. Ninety-three females aged 19,71 years were studied. Both devices were inserted into each patient in random order. Two attempts were allowed. Digital insertion was used for the first attempt and guided insertion for the second attempt. Oropharyngeal leak pressure and fibreoptic position were determined during cuff inflation from 0 to 40 ml in 10 ml increments. Gastric tube insertion was attempted if there was no gas leak from the drain tube. First attempt and overall insertion success were similar (LMA ProSealTM, 92% and 100%; LMA SupremeTM 95% and 100%). Guided insertion was always successful following failed digital insertion. Oropharyngeal leak pressure was 4,8 ml higher for the LMA ProSealTM over the inflation range (p < 0.001). Intracuff pressure was 16,35 cm higher for the LMA ProSealTM when the cuff volume was 20,40 ml (p < 0.001). There was an increase in oropharyngeal leak pressure with increasing cuff volume from 10 to 30 ml for both devices, but no change from 0 to 10 ml and 30,40 ml. There were no differences in the fibreoptic position of the airway or drain tube. The first attempt and overall insertion success for the gastric tube was similar (LMA ProSealTM 91% and 100%; LMA SupremeTM 92% and 100%). We conclude that ease of insertion, gastric tube placement and fibreoptic position are similar for the LMA ProSealTM and LMA SupremeTM in paralysed, anaesthetised females, but oropharyngeal leak pressure and intracuff pressure are higher for the LMA ProSealTM. [source] ORIGINAL ARTICLE: Comparison of guided insertion of the LMA ProSealÔ vs the i-gelÔANAESTHESIA, Issue 9 2010L. Gasteiger Summary In a randomised, non-crossover study, we tested the hypothesis that the ease of insertion using a duodenal tube guided insertion technique and the oropharyngeal leak pressure differ between the LMA ProSealÔ and the i-gelÔ in non-paralysed, anesthetised female subjects. One hundred and fifty-two females aged 19,70 years were studied. Insertion success rate, insertion time and oropharyngeal leak pressure were measured. First attempt and overall insertion success were similar (LMA ProSeal, 75/76 (99%) and 76/76 (100%); i-gel 73/75 (97%) and 75 (100%), respectively). Mean (SD) insertion times were similar (LMA ProSeal, 40 (16) s; i-gel 43 (21) s). Mean oropharyngeal leak pressure was 7 cmH2O higher with the LMA ProSeal (p < 0.0001). Insertion of the LMA ProSeal and i-gel is similarly easy using a duodenal tube guided technique, but the LMA ProSeal forms a more effective seal for ventilation. [source] Comparison of the Intersurgical SolusTM laryngeal mask airway and the i-gel supralaryngeal deviceANAESTHESIA, Issue 8 2010S. Amini Summary We compared the performance of the Intersurgical SolusTM laryngeal mask airway (LMA) with that of the i-gel in 120 patients of ASA physical status during general anaesthesia with respect to oropharyngeal leak pressure, peak airway pressure, airway manipulation, insertion time, fibreoptic view, ventilatory parameters, and peri-operative complications. After receiving a standardised induction of anaesthesia, either a Solus LMA (60 patients) or an i-gel (60 patients) was inserted. One hundred and fifteen patients completed the study. The leak pressure was significantly higher in the LMA group than the i-gel group (mean (SD) 22.7 (7.7) cmH2O vs 19.3 (7.1) cmH2O; p = 0.02). A better fibreoptic view of the larynx was obtained in patients in the LMA group (p = 0.02) compared to those in the i-gel group and less airway manipulation was required in the LMA group (p < 0.01). Both devices have good performance with very low peri-operative complications. However, the Solus LMA provides a better oropharyngeal seal, provides a better fibreoptic view, and requires less manipulation to secure the airway than the i-gel. [source] Appropriate laryngeal mask airway size for overweight and underweight childrenANAESTHESIA, Issue 1 2010H. J. Kim Summary The aim of this study was to compare conventional laryngeal mask airway sizing by weight with sizing by age in over- or underweight children. We studied 26 overweight (body mass index > 85th centile) and 26 underweight (body mass index < 15th centile) children. After general anaesthesia was induced, laryngeal mask airways sized by the patient's weight and by an ideal weight (estimated from the patient's age according to standardised tables) were inserted consecutively. In overweight children, oropharyngeal leak pressure was significantly greater when the laryngeal mask was sized by the patient's actual weight. On the other hand in underweight children, it was significantly greater when sized by the ideal weight. In conclusion, laryngeal mask airway sizing according to the manufacturer's weight-based recommendation is to be preferred in overweight children, but laryngeal mask airway size by an ideal weight estimated from the patient's age is a better choice in underweight children. [source] The Laryngeal Mask Airway SupremeTM, a single use laryngeal mask airway with an oesophageal vent.ANAESTHESIA, Issue 1 2009A randomised, anaesthetised patients, cross-over study with the Laryngeal Mask Airway ProSealTM in paralysed Summary The LMA SupremeTM is a new extraglottic airway device which brings together features of the LMA ProSealTM, FastrachTM and UniqueTM. We test the hypothesis that ease of insertion, oropharyngeal leak pressure, fibreoptic position and ease of gastric tube placement differ between the LMA ProSealTM and the LMA SupremeTM in paralysed anesthetised patients. Ninety-three females aged 19,71 years were studied. Both devices were inserted into each patient in random order. Two attempts were allowed. Digital insertion was used for the first attempt and guided insertion for the second attempt. Oropharyngeal leak pressure and fibreoptic position were determined during cuff inflation from 0 to 40 ml in 10 ml increments. Gastric tube insertion was attempted if there was no gas leak from the drain tube. First attempt and overall insertion success were similar (LMA ProSealTM, 92% and 100%; LMA SupremeTM 95% and 100%). Guided insertion was always successful following failed digital insertion. Oropharyngeal leak pressure was 4,8 ml higher for the LMA ProSealTM over the inflation range (p < 0.001). Intracuff pressure was 16,35 cm higher for the LMA ProSealTM when the cuff volume was 20,40 ml (p < 0.001). There was an increase in oropharyngeal leak pressure with increasing cuff volume from 10 to 30 ml for both devices, but no change from 0 to 10 ml and 30,40 ml. There were no differences in the fibreoptic position of the airway or drain tube. The first attempt and overall insertion success for the gastric tube was similar (LMA ProSealTM 91% and 100%; LMA SupremeTM 92% and 100%). We conclude that ease of insertion, gastric tube placement and fibreoptic position are similar for the LMA ProSealTM and LMA SupremeTM in paralysed, anaesthetised females, but oropharyngeal leak pressure and intracuff pressure are higher for the LMA ProSealTM. [source] A new supraglottic airway device: LMA-SupremeÔ, comparison with LMA-ProsealÔACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2009T. HOSTEN Background and objective: The LMA-SupremeÔ (S-LMAÔ) is a new supraglottic airway device that presents combined features of flexibility, curved structure and single use and a different cuff structure. The purpose of this study was to compare the oropharyngeal leak pressures (OLP) of LMA-ProsealÔ (P-LMAÔ) and S-LMAÔ. Methods: Sixty adult patients were prospectively and randomly allocated to undergo insertion of P-LMAÔ (n=30) or S-LMAÔ (n=30). The cuffs were inflated until the intracuff pressure (ICP) reached 60 cm H2O. Orogastric leak pressures, insertion times, first attempt success rates, fiberoptical assessment of position, cuff pressures, orogastric tube (OGT) placement and OGT insertion times were compared. Unblinded observers collected intraoperative data and blinded observers collected post-operative data. Results: The first insertion attempts and time taken to provide an effective airway were similar between the groups. Two patients (P-LMAÔ, n=1; S-LMAÔ, n=1) were intubated due to excessive oropharyngeal leak and in one patient (P-LMAÔ, n=1) due to failed OGT placement. OLPs were similar (P-LMAÔ; 26.9±6.6 S-LMAÔ; 26.1±5.2). ICP increased significantly in the P-LMAÔ at the 30 and 60 min during anesthesia (P-LMAÔ; 80.1±12.8, 92.9±14.4, S-LMAÔ; 68.3±10.9, 73.7±15.6). OGT placement was successful in all patients in the S-LMAÔ, but failed in five patients in the P-LMAÔ (P=0.02). Fiberoptically determined anatomic position was better with the P-LMAÔ (P=0.03). Conclusion: Our findings suggest that S-LMAÔ had leak pressures similar to the P-LMAÔ, and this new airway device proved to be successful during both spontaneous and positive pressure ventilation. [source] | ||||||||||