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International Anesthesiology Clinics 1997
Review
Topics: Anesthesia; Humans; Intubation, Intratracheal; Laryngeal Masks
PubMed: 9361976
DOI: 10.1097/00004311-199703530-00007 -
Anaesthesia and Intensive Care Dec 1996
Topics: Equipment Failure; Humans; Laryngeal Masks
PubMed: 8971332
DOI: No ID Found -
Anesthesiology Nov 1992
Topics: Contraindications; Humans; Laryngeal Masks
PubMed: 1443734
DOI: 10.1097/00000542-199211000-00001 -
The New England Journal of Medicine Nov 2013This video demonstrates the placement of a laryngeal mask airway, an alternative airway device that is both efficacious and easy to place. The laryngeal mask airway is... (Review)
Review
This video demonstrates the placement of a laryngeal mask airway, an alternative airway device that is both efficacious and easy to place. The laryngeal mask airway is routinely used for patients receiving general anesthesia and, increasingly, in patient resuscitation.
Topics: Cardiopulmonary Resuscitation; Emergencies; Heart Arrest; Humans; Laryngeal Masks
PubMed: 24224639
DOI: 10.1056/NEJMvcm0909669 -
AANA Journal Aug 1997The laryngeal mask airway (LMA) is an important new tool for managing the emergency airway. In a variety of emergency situations, the LMA may be considered instead of... (Review)
Review
The laryngeal mask airway (LMA) is an important new tool for managing the emergency airway. In a variety of emergency situations, the LMA may be considered instead of the face mask or the endotracheal tube. Furthermore, the LMA can be used as an aid to intubation and as a bridge to more secure means to control the airway. The primary risk with the LMA is aspiration of gastric contents. Anesthetists should be familiar with its advantages, risks, indications, and uses.
Topics: Airway Obstruction; Emergencies; Humans; Intubation, Intratracheal; Laryngeal Masks; Nurse Anesthetists
PubMed: 9281919
DOI: No ID Found -
British Journal of Hospital Medicine... Jan 2018Supraglottic airway devices have increasingly been used in anaesthesia since their invention in 1982. Now over half of general anaesthetic cases in the UK use them, and... (Review)
Review
Supraglottic airway devices have increasingly been used in anaesthesia since their invention in 1982. Now over half of general anaesthetic cases in the UK use them, and they have vital roles in difficult airway algorithms, pre-hospital use and emergency medicine. This article presents the current evidence regarding the complications of these devices, and compares these devices and endotracheal intubation. The technology of the newer generation devices has improved the safety profile, and they may be considered a better choice than endotracheal tubes in some cases. There may be a case for using these devices in a wider range of surgical and non-surgical cases.
Topics: Airway Management; Anesthesia, General; Humans; Intubation, Intratracheal; Laryngeal Masks
PubMed: 29315046
DOI: 10.12968/hmed.2018.79.1.31 -
Saudi Medical Journal Nov 2018To evaluate and compare the performances of new types of supraglottic airway devices (SADs) with endotracheal intubation regarding their ease of insertions,... (Comparative Study)
Comparative Study
To evaluate and compare the performances of new types of supraglottic airway devices (SADs) with endotracheal intubation regarding their ease of insertions, perioperative complications, and effects on hemodynamic parameters and peak airway pressures in laparascopic cholecystectomy (LC). Methods: One hundred and fourteen patients with ASA 1-2 physical status scheduled for elective LC were recruited for this prospective randomized controlled trial. The study was completed between January 2016 and January 2017 in Adiyaman University Research and Educational Hospital, Adiyaman, Turkey. The patients were divided into AuraGain(Ambu, Ballerup, Denmark) (n=38), i-Gel® (Intersurgical Ltd, UK) (n=35), and endotracheal tube (ETT)(n=32) groups. Ease of insertion, airway pressures, complications, and hemodynamic variables were compared. Results: The trial was completed with 105 patients. Ease of insertion for SADs which was evaluated with insertion procedure duration, attempts, first insertion success rates, and oropharyngeal leak pressures were similar between the groups. Heart rate, systolic and diastolic arterial pressures, and peak airway pressures were significantly lower in the AuraGain and i-Gel® groups, compared with the ETT, p less than 0.017. Conclusion: Both AuraGain and i-Gel® SADs are comparable with ETT used for airway control in general anesthesia for LC, regarding application ease and perioperative complications. Favorable hemodynamic responses to AuraGain and i-Gel® SADs may put them in a better place than ETT.
Topics: Adult; Anesthesia, General; Blood Pressure; Cholecystectomy, Laparoscopic; Female; Heart Rate; Humans; Laryngeal Masks; Male; Maximal Respiratory Pressures; Middle Aged
PubMed: 30397706
DOI: 10.15537/smj.2018.11.22346 -
The Cochrane Database of Systematic... Jul 2017The development of supraglottic airway devices has revolutionized airway management during general anaesthesia. Two devices are widely used in clinical practice to... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
The development of supraglottic airway devices has revolutionized airway management during general anaesthesia. Two devices are widely used in clinical practice to facilitate positive pressure ventilation: the ProSeal laryngeal mask airway (pLMA) and the Classic laryngeal mask airway (cLMA). It is not clear whether these devices have important clinical differences in terms of efficacy or complications.
OBJECTIVES
To compare the effectiveness of the ProSeal laryngeal mask airway (pLMA) and the Classic LMA (cLMA) for positive pressure ventilation in adults undergoing elective surgery.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 3) in the Cochrane Library; MEDLINE (Ovid SP, 1997 to April 2017); Embase (Ovid SP, 1997 to April 2017); the Institute for Scientific Information (ISI) Web of Science (1946 to April 2017); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO host, 1982 to April 2017).We searched trial registries for ongoing studies to April 2017.We did not impose language restrictions. We restricted our search to the time from 1997 to April 2017 because pLMA was introduced into clinical practice in the year 2000.
SELECTION CRITERIA
We included randomized controlled trials (RCTs) that compared the effectiveness of pLMA and cLMA for positive pressure ventilation in adults undergoing elective surgery. We planned to include only data related to the first phase of cross-over RCTs.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by the Cochrane Collaboration.
MAIN RESULTS
We included eight RCTs that involved a total of 829 participants (416 and 413 participants in the pLMA and cLMA groups, respectively). We identified six cross-over studies that are awaiting classification; one is completed but has not been published, and data related to the first treatment period for the other five studies were not yet available. Seven included studies provided data related to the primary outcome, and eight studies provided data related to more than one secondary outcome.Our analysis was hampered by the fact that a large proportion of the included studies reported no events in either study arm. No studies reported significant differences between devices in relation to the primary review outcome: failure to adequately mechanically ventilate. We evaluated this outcome by assessing two variables: inadequate oxygenation (risk ratio (RR) 0.75, 95% confidence interval (CI) 0.17 to 3.31; four studies, N = 617) and inadequate ventilation (not estimable; one study, N = 80).More time was required to establish an effective airway using pLMA (mean difference (MD) 10.12 seconds, 95% CI 5.04 to 15.21; P < 0.0001; I² = 73%; two studies, N = 434). Peak airway pressure during positive pressure ventilation was lower in cLMA participants (MD 0.84, 95% CI 0.02 to 1.67; P = 0.04; I² = 0%; four studies, N = 259). Mean oropharyngeal leak (OPL) pressure was higher in pLMA participants (MD 6.93, 95% CI 4.23 to 9.62; P < 0.00001; I² = 87%; six studies, N = 709).The quality of evidence for all outcomes, as assessed by GRADE score, is low mainly owing to issues related to blinding and imprecision.Data show no important differences between devices with regard to failure to insert the device, use of an alternate device, mucosal injury, sore throat, bronchospasm, gastric insufflation, regurgitation, coughing, and excessive leak. Data were insufficient to allow estimation of differences for obstruction related to the device. None of the studies reported postoperative nausea and vomiting as an outcome.
AUTHORS' CONCLUSIONS
We are uncertain about the effects of either of the airway devices in terms of failure of oxygenation or ventilation because there were very few events. Results were uncertain in terms of differences for several complications. Low-quality evidence suggests that the ProSeal laryngeal mask airway makes a better seal and therefore may be more suitable than the Classic laryngeal mask airway for positive pressure ventilation. The Classic laryngeal mask airway may be quicker to insert, but this is unlikely to be clinically meaningful.
Topics: Adult; Elective Surgical Procedures; Humans; Laryngeal Masks; Oxygen Consumption; Positive-Pressure Respiration; Randomized Controlled Trials as Topic; Treatment Failure
PubMed: 28727896
DOI: 10.1002/14651858.CD009026.pub2 -
Anasthesiologie, Intensivmedizin,... May 1993
Topics: England; Humans; Laryngeal Masks
PubMed: 8318596
DOI: 10.1055/s-2007-998895 -
Anesthesiology Jun 2012
Topics: Female; Humans; Laryngeal Masks; Male
PubMed: 22504150
DOI: 10.1097/ALN.0b013e318255e6cb