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Journal of Feline Medicine and Surgery Aug 2022Airway management during anaesthesia in cats is always a demanding task and is associated with several complications. The aim of this study was to evaluate the...
OBJECTIVES
Airway management during anaesthesia in cats is always a demanding task and is associated with several complications. The aim of this study was to evaluate the practicability and complications during feline-specific laryngeal mask placement in anaesthetised cats as an alternative to endotracheal intubation.
METHODS
In this prospective clinical study, laryngeal masks were placed in 148 anaesthetised cats. Success of placement was evaluated by capnography.
RESULTS
Placement was possible at the first attempt in 136 cats, at the second attempt in eight cats and at the third attempt in one cat. In one cat, placement was not possible. Two cats were excluded. Failure to position the laryngeal mask at the first attempt was not different between laryngeal mask sizes ( = 0.313) or positioning during placement ( = 0.406). In nine cats, the laryngeal mask dislocated during the procedure. Dislocation occurred more often in the dorsal position than in the sternal ( = 0.018) and right lateral positions ( = 0.046). Mucous obstruction of the laryngeal mask occurred in one of these cats and regurgitation in another. Material-related issues, such as disconnection of the parts of the laryngeal mask and leakage of the balloon, were observed in 2/8 laryngeal masks.
CONCLUSIONS AND RELEVANCE
The placement of a feline-specific laryngeal mask was easy to perform. In about 7% of the cases, replacement of the device was required due to mispositioning or dislocation. Full monitoring, including capnography, should be provided to uncover dislocation and airway obstruction immediately.
Topics: Anesthesia; Animals; Cats; Intubation, Intratracheal; Laryngeal Masks; Prospective Studies
PubMed: 34663126
DOI: 10.1177/1098612X211050612 -
Minerva Anestesiologica Oct 2022The aim of this study was to observe changes in the laryngeal vestibule under head extension or in neutral position with or without the chin lifted after anesthesia...
BACKGROUND
The aim of this study was to observe changes in the laryngeal vestibule under head extension or in neutral position with or without the chin lifted after anesthesia induction.
METHODS
After anesthesia induction, a flexible bronchoscope was used to observe the status of the laryngeal vestibule under four positions. Then, the degree of laryngeal vestibule closure was graded. The grading scores and the incidence of severe closure under these four positions were compared. The factors that may be related to the severe closure and potential contributions of head extension and chin lifting were also analyzed. When laryngeal mask was applied, the change in the laryngeal vestibule state was observed through the laryngeal mask after placement.
RESULTS
The closure scores of the laryngeal vestibule were significantly different among these four positions (P<0.001). The incidence of severe closure was highest in the neutral head position without the chin lifted. Regression analysis showed that age and snoring were associated with severe closure of the laryngeal vestibule. Both head extension and chin lifting could decrease the risk of severe closure of the laryngeal vestibule, and head extension was more important than chin lift. After laryngeal mask placement, the severely closed laryngeal vestibule can be further opened up to grades 1-2.
CONCLUSIONS
The neutral position of the head after anesthesia induction may cause complete closure of the laryngeal vestibule. The best way to keep the laryngeal vestibule open is head extension with the chin lifted, while most the laryngeal vestibules will be severely closed in the neutral position without the chin lifted.
Topics: Anesthesia, General; Humans; Laryngeal Masks; Larynx; Posture
PubMed: 35546734
DOI: 10.23736/S0375-9393.22.16438-2 -
Medicine Nov 2022This study is conducted to evaluate the efficacy and safety of using multifunctional intubation laryngeal masks with normal frequency jet ventilation in airway...
OBJECTIVE
This study is conducted to evaluate the efficacy and safety of using multifunctional intubation laryngeal masks with normal frequency jet ventilation in airway interventional therapy.
METHODS
A total of 200 patients receiving airway interventional therapy were enrolled in this retrospective study and were divided into 2 groups (group M and group P) by doctors in our hospital to compare the effect of different laryngeal masks. Group M used common laryngeal masks and an anesthesia machine for positive pressure ventilation while group P took multifunctional intubation laryngeal masks and used a jet ventilator for normal frequency jet ventilation. The patients' mean arterial pressure, heart rate, arterial oxygen partial pressure (PaO2) and arterial carbon dioxide partial pressure (PaCO2), and the operation time, recovery score and the patients' and doctors' satisfaction levels were compared between the 2 groups.
RESULTS
Both groups were hemodynamically stable, and their PaO2 levels were significantly higher before the operation than that during and after the operation (P < .05). Compared with group M, the PaCO2 level of group P was more stable both during and after the operation, and this difference was statistically significant (P < .05). There was no statistically significant difference in terms of the 2 group's operating time, recovery score, and patients' satisfaction levels (P > .05). However, the satisfaction levels of doctors in group P were higher than that in group M, and this difference was statistically significant (P < .05).
CONCLUSION
As statistics show, the intraoperative hemodynamics and PaO2 and PaCO2 levels were stable, and patients, surgeons and anesthesia operators were satisfied. Therefore, it is feasible to apply multifunctional intubation laryngeal masks with normal frequency jet ventilation in airway interventional therapy and it is a safe and ideal way to ensure ventilation.
Topics: Humans; Laryngeal Masks; Retrospective Studies; High-Frequency Jet Ventilation; Blood Gas Analysis; Oxygen
PubMed: 36397451
DOI: 10.1097/MD.0000000000031388 -
Minerva Anestesiologica Jun 2018
Comparing two laryngeal masks: the twin importance of a quantitative measure of the oropharyngeal sealing pressure, and the scrupulous avoidance of an excessive intracuff pressure.
Topics: Adult; Humans; Laryngeal Masks; Male; Pressure; Prospective Studies
PubMed: 29516709
DOI: 10.23736/S0375-9393.18.12645-9 -
Pneumologie (Stuttgart, Germany) Nov 2019
Topics: Humans; Laryngeal Masks; Practice Guidelines as Topic
PubMed: 31715637
DOI: 10.1055/a-0947-3446 -
Korean Journal of Anesthesiology Dec 2019
Topics: Anesthesia, General; Equipment Design; Humans; Intubation, Intratracheal; Laryngeal Masks
PubMed: 31813205
DOI: 10.4097/kja.19417 -
BMC Anesthesiology Jul 2022In perioperative care or intensive care units, the expansion lines of endotracheal tubes (ETTs) or laryngeal mask airways (LMAs) may be accidentally cut off during...
BACKGROUND
In perioperative care or intensive care units, the expansion lines of endotracheal tubes (ETTs) or laryngeal mask airways (LMAs) may be accidentally cut off during medical procedures. We designed a simple method for repairing damaged ETT and LMA expansion lines.
METHODS
In this in vitro study, ETT (n = 20) or LMA (n = 20) models were each categorized into experimental (n = 10) and control (n = 10) groups. In the experimental groups, the expansion lines were cut in the middle, and a 22G intravenous catheter was inserted into the broken end of each expansion line. The time taken to repair the expansion lines was recorded in both experimental groups. The repaired expansion lines in both groups were tested for visible underwater air leakage with cuffs under high pressure (120 cm H2O). After 15 h, the cuff pressure and tensile strength of the expansion lines were measured.
RESULTS
The overall time required to repair the expansion line was 27.8 ± 1.5 s in the ETT group and 20.4 ± 1.1 s in the LMA group. When the cuff pressure was increased to 120 cmHO, no air leakage was observed in the experimental LMA and ETT groups. The mean difference in the cuff pressures of the control and experimental groups was insignificant for both, ETT (9.50 ± 1.29 vs. 9.50 ± 1.08 cmHO, 95% CI = - 1.11 to 1.11 cmHO, P = 1.00) and LMA (34.1 ± 1.10 cmHO vs. 34.5 ± 0.97 cmHO, 95% CI = - 0.57 to 1.37 cmHO, P = 0.40) groups, The tensile strength and the force required to pull apart the expansion lines in the experimental groups were lower than those in the control groups for ETTs (3.32 ± 0.37 N vs. 35.03 ± 4.47 N, 95% CI = - 34.69 to - 28.72 N, P < 0.0001) and LMAs (36.55 ± 2.20 N vs. 26.18 ± 1.67 N, 95% CI = - 12.21 to - 8.53 N, P < 0.0001).
CONCLUSION
An intravenous catheter can be directly inserted into the damaged ETT or LMA expansion lines; it is a simple, rapid, and effective repair method.
Topics: Administration, Intravenous; Catheters; Intubation, Intratracheal; Laryngeal Masks
PubMed: 35883053
DOI: 10.1186/s12871-022-01776-5 -
Anaesthesia Oct 2014We systematically reviewed 31 adult randomised clinical trials of the i-gel(®) vs laryngeal mask airway. The mean (95% CI) leak pressure difference and relative risk... (Comparative Study)
Comparative Study Meta-Analysis Review
We systematically reviewed 31 adult randomised clinical trials of the i-gel(®) vs laryngeal mask airway. The mean (95% CI) leak pressure difference and relative risk (95% CI) of insertion on the first attempt were similar: 0.40 (-1.23 to 2.02) cmH2 O and 0.98 (0.95-1.01), respectively. The mean (95% CI) insertion time and the relative risk (95% CI) of sore throat were less with the i-gel: by 1.46 (0.33-2.60) s, p = 0.01, and 0.59 (0.38-0.90), p = 0.02, respectively. The relative risk of poor fibreoptic view through the i-gel was 0.29 (0.16-0.54), p < 0.0001. All outcomes displayed substantial heterogeneity, I(2) ≥ 75%. Subgroup analyses did not decrease heterogeneity, but suggested that insertion of the i-gel was faster than for first-generation laryngeal mask airways and that the i-gel leak pressure was higher than first generation, but lower than second-generation, laryngeal mask airways. A less frequent sore throat was the main clinical advantage of the i-gel.
Topics: Adult; Humans; Laryngeal Masks; Pharyngitis; Randomized Controlled Trials as Topic
PubMed: 25040063
DOI: 10.1111/anae.12772 -
Anaesthesia May 1999Sore throat is a common postoperative complaint, occurring most often following tracheal intubation. Factors such as tracheal-tube size and cuff design have been shown... (Review)
Review
Sore throat is a common postoperative complaint, occurring most often following tracheal intubation. Factors such as tracheal-tube size and cuff design have been shown to be important causative factors. Routine tracheal intubation for elective surgical procedures can result in pathological changes, trauma and nerve damage which may also account for postoperative throat symptoms. Sore throat following the use of a laryngeal mask appears to be related to the technique of insertion but the contribution of intracuff pressure remains to be clarified. It would appear, however, that high intracuff pressure is associated with nerve palsies due to neuropraxia and nerve compression. Careful insertion techniques for both the tracheal tube and laryngeal mask are of paramount importance in the prevention of airway trauma and postoperative sore throat.
Topics: Humans; Intubation, Intratracheal; Laryngeal Masks; Pharyngitis
PubMed: 10995141
DOI: 10.1046/j.1365-2044.1999.00780.x -
PloS One 2015Conflicting results have been reported for the i-gel and the laryngeal mask airway proseal (LMA-P) during general anesthesia. The objective of the current investigation... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Conflicting results have been reported for the i-gel and the laryngeal mask airway proseal (LMA-P) during general anesthesia. The objective of the current investigation was to compare the efficacy and safety of the i-gel vs. the LMA-P during general anesthesia.
METHODS
Two authors performed searches of MEDLINE, EMBASE, CENTRAL, and Google Scholar to identify randomized clinical trials that compared the LMA-P with the i-gel during general anesthesia. A meta -analysis was performed using both random and fixed-effect models. Publication bias was evaluated using Begg's funnel plot and Egger's linear regression test.
RESULTS
Twelve randomized clinical trials met the eligibility criteria. There were no significant differences in insertion success rate at the first attempt (risk ratio [RR] 1.01, 95% confidence interval [CI] 0.97, 1.06), ease of insertion (RR 1.14, 95% CI 0.93, 1.39), oropharyngeal leak pressure (OLP) (MD -1.98, 95% CI -5.41, 1.45), quality of fiberoptic view (RR 1.00, 95% CI 0.91, 1.10) and success rate of gastric tube insertion (RR 1.07, 95% CI 0.98, 1.18) between the i-gel and the LMA-P, respectively. The i-gel had a shorter insertion time than the LMA-P (MD -3.99, 95% CI -7.13, -0.84) and a lower incidence of blood staining on the device (RR 0.26, 95% CI 0.14, 0.49), sore throat (RR 0.28, 95% CI 0.15, 0.50) and dysphagia (RR 0.27, 95% CI 0.10, 0.74).
CONCLUSIONS
Both devices were comparable in ease of insertion to insert and both had sufficient OLP to provide a reliable airway. Only a few minor complications were reported. The i-gel was found to have fewer complications (blood staining, sore throat, dysphagia) than the LMA-P and offers certain advantages over the LMA-P in adults under general anesthesia.
Topics: Anesthesia, General; Humans; Laryngeal Masks
PubMed: 25812135
DOI: 10.1371/journal.pone.0119469