Efficacy and safety of three inflation methods of the laryngeal mask airway Ambu® Auraonce™: a randomized controlled study.

Cuff inflating volume Intracuff pressure Laryngeal mask Manometer Oropharyngeal leak pressure Postoperative complications

Journal

Journal of clinical monitoring and computing
ISSN: 1573-2614
Titre abrégé: J Clin Monit Comput
Pays: Netherlands
ID NLM: 9806357

Informations de publication

Date de publication:
04 Aug 2023
Historique:
received: 10 01 2023
accepted: 20 07 2023
medline: 4 8 2023
pubmed: 4 8 2023
entrez: 4 8 2023
Statut: aheadofprint

Résumé

The laryngeal mask airway (LMA) is commonly used for airway management. Cuff hyperinflation has been associated with complications, poor ventilation and increased risk of gastric insufflation. This study was designed to determine the best cuff inflation method of AuraOnce™ LMA during bronchoscopy and EBUS (Endobronquial Ultrasound Bronchoscopy) procedure. We designed a Randomized controlled, doble-blind, clinical trial to compare the efficacy and safety of three cuff inflation methods of AuraOnce™ LMA. 210 consenting patients scheduled for EBUS procedure under general anesthesia, using AuraOnce™ LMA were randomized into three groups depending on cuff insufflation: residual volume (RV), half of the maximum volume (MV), unchanged volume (NV). Parameters regarding intracuff pressure (IP), airway leak pressure (OLP), leakage volume (LV) were assessed, as well as postoperative complications (PC). 201 (95.7%) patients completed the study. Mean IP differed between groups (MV: 59.4 ± 32.4 cm H

Identifiants

pubmed: 37540323
doi: 10.1007/s10877-023-01061-x
pii: 10.1007/s10877-023-01061-x
doi:

Banques de données

ClinicalTrials.gov
['NCT04769791']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer Nature B.V.

Références

O’Neill B, Templeton JJ, Caramico L, Schreiner MS. The laryngeal mask airway in pediatric patients: factors affecting ease of use during insertion and emergence. Anesth Analg. 1994;78(4):659–62.
pubmed: 8135383
Bick E, Bailes I, Patel A, Brain AI. Fewer sore throats and a better seal: why routine manometry for laryngeal mask airways must become the standard of care. Anaesthesia. 2014;69(12):1304–8.
doi: 10.1111/anae.12902 pubmed: 25303083
Kim MS, Bai SJ, Oh JT, Youm SM, Lee JR. Comparison of 2 cuff inflation methods before insertion of laryngeal mask airway for safe use without cuff manometer in children. Am J Emerg Med. 2013;31(2):346–52.
doi: 10.1016/j.ajem.2012.08.037 pubmed: 23158592
Matta BF, Marsh DS, Nevin M. Laryngeal mask airway: a more successful method of insertion. J Clin Anesth. 1995;7(2):132–5.
doi: 10.1016/0952-8180(94)00027-2 pubmed: 7598921
Brimacombe J, Berry A. Insertion of the laryngeal mask airway–a prospective study of four techniques. Anaesth Intensive Care. 1993;21(1):89–92.
doi: 10.1177/0310057X9302100121 pubmed: 8447615
Moon BE, Kim MS, Lee JR. A simple method of partial inflation of the LMA cuff before insertion in children to allow cuff pressure without adjustment after insertion. Korean J Anesthesiol. 2012;62(6):524–8.
doi: 10.4097/kjae.2012.62.6.524 pubmed: 22778887 pmcid: 3384789
Kim MS, Lee JR, Shin YS, Chung JW, Lee KH, Ahn KR. Comparison of 2 cuff inflation methods of laryngeal mask airway classic for safe use without cuff manometer in adults. Am J Emerg Med. 2014;32(3):237–42.
doi: 10.1016/j.ajem.2013.11.029 pubmed: 24360025
Seet E, Yousaf F, Gupta S, Subramanyam R, Wong DT, Chung F. Use of manometry for laryngeal mask airway reduces postoperative pharyngolaryngeal adverse events: a prospective, randomized trial. Anesthesiology. 2010;112(3):652–7.
doi: 10.1097/ALN.0b013e3181cf4346 pubmed: 20179502
Licina A, Chambers NA, Hullett B, Erb TO, von Ungern-Sternberg BS. Lower cuff pressures improve the seal of pediatric laryngeal mask airways. Paediatr Anaesth. 2008;18(10):952–6.
doi: 10.1111/j.1460-9592.2008.02706.x pubmed: 18647269
Hernandez MR, Klock PA Jr, Ovassapian A. Evolution of the extraglottic airway: a review of its history, applications, and practical tips for success. Anesth Analg. 2012;114(2):349–68.
doi: 10.1213/ANE.0b013e31823b6748 pubmed: 22178627
O’Kelly SW, Heath KJ, Lawes EG. A study of laryngeal mask inflation. Pressures exerted on the pharynx. Anaesthesia. 1993;48(12):1075–8.
doi: 10.1111/j.1365-2044.1993.tb07532.x pubmed: 8285330
Brimacombe J, Keller C, Pühringer F. Pharyngeal mucosal pressure and perfusion: a fiberoptic evaluation of the posterior pharynx in anesthetized adult patients with a modified cuffed oropharyngeal airway. Anesthesiology. 1999;91(6):1661–5.
pubmed: 10598608
Lloyd Jones FR, Hegab A. Case report. Recurrent laryngeal nerve palsy after laryngeal mask airway insertion. Anaesthesia. 1996;51(2):171–2.
doi: 10.1111/j.1365-2044.1996.tb07707.x pubmed: 8779375
Brimacombe J, Clarke G, Keller C. Lingual nerve injury associated with the ProSeal laryngeal mask airway: a case report and review of the literature. Br J Anaesth. 2005;95(3):420–3.
doi: 10.1093/bja/aei187 pubmed: 16006489
Wadełek J, Kolbusz J, Orlicz P, Staniaszek A. Tapia’s syndrome after arthroscopic shoulder stabilisation under general anaesthesia and LMA. Anaesthesiol Intensive Ther. 2012;44(1):31–4.
pubmed: 23801511
Cros AM, Pitti R, Conil C, Giraud D, Verhulst J. Severe dysphonia after use of a laryngeal mask airway. Anesthesiology. 1997;86(2):498–500.
doi: 10.1097/00000542-199702000-00027 pubmed: 9054270
Brimacombe I, Keller C. Recurrent laryngeal nerve injury with the laryngeal mask. Anasthesiol Intensivmed Notfallmed Schmerzther. 1999;34(3):189–92.
doi: 10.1055/s-1999-176 pubmed: 10234417
Laxton CH, Kipling R. Lingual nerve paralysis following the use of the laryngeal mask airway. Anaesthesia. 1996;51(9):869–70.
doi: 10.1111/j.1365-2044.1996.tb12621.x pubmed: 8882254
Rieger A, Brunne B, Striebel HW. Intracuff pressures do not predict laryngopharyngeal discomfort after use of the laryngeal mask airway. Anesthesiology. 1997;87(1):63–7.
doi: 10.1097/00000542-199707000-00009 pubmed: 9232135
Hell J, Pohl H, Spaeth J, et al. Incidence of gastric insufflation at high compared with low laryngeal mask cuff pressure: a randomised controlled cross-over trial. Eur J Anaesthesiol. 2021;38(2):146–56.
doi: 10.1097/EJA.0000000000001269 pubmed: 32740320
Wallace CJ, Chambers NA, Erb TO, von Ungern-Sternberg BS. Pressure volume curves of paediatric laryngeal mask airways. Anaesthesia. 2009;64(5):527–31.
doi: 10.1111/j.1365-2044.2008.05819.x pubmed: 19413823
Maino P, Dullenkopf A, Keller C, Bernet-Buettiker V, Weiss M. Cuff filling volumes and pressures in pediatric laryngeal mask airways. Paediatr Anaesth. 2006;16(1):25–30.
doi: 10.1111/j.1460-9592.2005.01672.x pubmed: 16409525
Keller C, Brimacombe JR, Keller K, Morris R. Comparison of four methods for assessing airway sealing pressure with the laryngeal mask airway in adult patients. Br J Anaesth. 1999;82(2):286–7.
doi: 10.1093/bja/82.2.286 pubmed: 10365012
Ruananukun N, Watcharotayangul J, Jeeranukosol S, Komonhirun R. Correlation and variation of cuff inflating volumes and pressures in different adult models of laryngeal mask: a prospective randomized trial. BMC Anesthesiol. 2020;20(1):108.
doi: 10.1186/s12871-020-01028-4 pubmed: 32380954 pmcid: 7206679
Ghai B, Sethi S, Ram J, Wig J. Cuff filling volumes for pediatric classic laryngeal mask airways: comparison of clinical end points versus adjusted cuff pressure. Paediatr Anaesth. 2013;23(2):122–6.
doi: 10.1111/pan.12023 pubmed: 22985184
Brimacombe J, Berry A. A proposed fiber-optic scoring system to standardize the assessment of laryngeal mask airway position. Anesth Analg. 1993;76(2):457.
pubmed: 8424538
Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth. 1995;7(1):89–91.
doi: 10.1016/0952-8180(94)00001-K pubmed: 7772368
Al-Shaikh B, George William M, Van Zundert AA. Using atmospheric pressure to inflate the cuff of the Portex Laryngeal Mask. Anaesthesia. 2005;60(3):296–7.
doi: 10.1111/j.1365-2044.2005.04135.x pubmed: 15710025
Ghai B, Wig J. Comparison of different techniques of laryngeal mask placement in children. Curr Opin Anaesthesiol. 2009;22(3):400–4.
doi: 10.1097/ACO.0b013e3283294d06 pubmed: 19434792
Hockings L, Heaney M, Chambers NA, Erb TO, von Ungern-Sternberg BS. Reduced air leakage by adjusting the cuff pressure in pediatric laryngeal mask airways during spontaneous ventilation. Paediatr Anaesth. 2010;20(4):313–7.
doi: 10.1111/j.1460-9592.2010.03277.x pubmed: 20470334
Baidya DK, Chandralekha, Darlong V, Pandey R, Maitra S, Khanna P. Comparative efficacy and safety of the Ambu (®) AuraOnce (™) laryngeal mask airway during general anaesthesia in adults: a systematic review and meta-analysis. Anaesthesia. 2014;69(9):1023–32.
doi: 10.1111/anae.12682 pubmed: 24801012
Francksen H, Bein B, Cavus E, et al. Comparison of LMA Unique, Ambu laryngeal mask and soft seal laryngeal mask during routine surgical procedures. Eur J Anaesthesiol. 2007;24(2):134–40.
doi: 10.1017/S0265021506001219 pubmed: 16895620
López AM, Valero R, Bovaira P, Pons M, Sala-Blanch X, Anglada T. A clinical evaluation of four disposable laryngeal masks in adult patients. J Clin Anesth. 2008;20(7):514–20.
doi: 10.1016/j.jclinane.2008.05.015 pubmed: 19019649
Williams DL, Zeng JM, Alexander KD, Andrews DT. Randomised comparison of the AMBU AuraOnce Laryngeal Mask and the LMA Unique Laryngeal Mask Airway in spontaneously breathing adults. Anesthesiol Res Pract. 2012;2012:405812.
pubmed: 22505884 pmcid: 3299248
Figueredo E, Vivar-Diago M, Muñoz-Blanco F. Laryngo-pharyngeal complaints after use of the laryngeal mask airway. Can J Anaesth. 1999;46(3):220–5.
doi: 10.1007/BF03012599 pubmed: 10210044
Brimacombe J, Holyoake L, Keller C, et al. Pharyngolaryngeal, neck, and jaw discomfort after anesthesia with the face mask and laryngeal mask airway at high and low cuff volumes in males and females. Anesthesiology. 2000;93(1):26–31.
doi: 10.1097/00000542-200007000-00009 pubmed: 10861142

Auteurs

Teresa Prim (T)

Department of Anesthesiology and Reanimation Surgical Intensive Care, Hospital Universitario La Paz /Cantoblanco/Carlos III, Madrid, Spain. TERESA.PRIM@SALUD.MADRID.ORG.

Nicolas Brogly (N)

Department of Anesthesiology and Reanimation Surgical Intensive Care, Hospital Universitario La Paz /Cantoblanco/Carlos III, Madrid, Spain.

Emilia Guasch (E)

Department of Anesthesiology and Reanimation Surgical Intensive Care, Hospital Universitario La Paz /Cantoblanco/Carlos III, Madrid, Spain.

Jesús Díez (J)

Department of Biostatistics, Hospital Universitario La Paz, Pº de la Castellana, 261, Madrid, 28046, Spain.

Fernando Gilsanz (F)

Department of Surgery, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, Madrid, 28029, Spain.

Classifications MeSH