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Emergence characteristics and postoperative laryngopharyngeal morbidity with the laryngeal mask airway: a comparison of high versus low initial cuff volume.
Anaesthesia. 2000 Apr; 55(4):338-43.A

Abstract

In this study we tested the hypothesis that the initial cuff volume of the laryngeal mask airway influences emergence characteristics and postoperative laryngopharyngeal morbidity. One hundred and sixty adult patients undergoing minor surgery were randomly assigned for airway management with the laryngeal mask airway with either a fully inflated cuff (LMA-High) or a semi-inflated cuff (LMA-Low). Anaesthesia was with propofol, nitrous oxide, oxygen and isoflurane. Following insertion, the cuff was inflated with either 15 or 30 ml for the size 4 (females) and 20 or 40 ml for the size 5 (males). At the end of surgery, a blinded observer documented the presence or absence of adverse airway events (hypoxia, hypercapnea, coughing, retching, regurgitation/vomiting, airway obstruction, hypoventilation, hiccupping, biting, body movement or shivering) during every 1 min epoch and cardiorespiratory variables (heart rate, mean blood pressure, arterial oxygen saturation, end-tidal carbon dioxide and respiratory rate) every 5 min until the patient was awake and the laryngeal mask airway removed. Patients were interviewed about pharyngolaryngeal morbidity (sore throat, dysphonia and dysphagia) immediately before leaving the postanaesthesia care unit and 18-24 h following surgery. Analysis by epoch showed more partial airway obstruction in the LMA-High group, but analysis by patient numbers revealed no difference. Heart rate was slightly higher in the LMA-High group upon arrival in the postanaesthesia care unit, but otherwise there were no differences in cardiorespiratory responses. Sore throat and dysphagia were more common in the LMA-High group. We conclude that, in general, emergence characteristics with the laryngeal mask airway are not influenced by the volume of air used to inflate the cuff, but that postoperative sore throat and dysphagia are more likely at high initial cuff volumes.

Authors+Show Affiliations

Department of Anaesthesia and Intensive Care, Cairns Base Hospital, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

10781119

Citation

Brimacombe, J, et al. "Emergence Characteristics and Postoperative Laryngopharyngeal Morbidity With the Laryngeal Mask Airway: a Comparison of High Versus Low Initial Cuff Volume." Anaesthesia, vol. 55, no. 4, 2000, pp. 338-43.
Brimacombe J, Holyoake L, Keller C, et al. Emergence characteristics and postoperative laryngopharyngeal morbidity with the laryngeal mask airway: a comparison of high versus low initial cuff volume. Anaesthesia. 2000;55(4):338-43.
Brimacombe, J., Holyoake, L., Keller, C., Barry, J., Mecklem, D., Blinco, A., & Weidmann, K. (2000). Emergence characteristics and postoperative laryngopharyngeal morbidity with the laryngeal mask airway: a comparison of high versus low initial cuff volume. Anaesthesia, 55(4), 338-43.
Brimacombe J, et al. Emergence Characteristics and Postoperative Laryngopharyngeal Morbidity With the Laryngeal Mask Airway: a Comparison of High Versus Low Initial Cuff Volume. Anaesthesia. 2000;55(4):338-43. PubMed PMID: 10781119.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergence characteristics and postoperative laryngopharyngeal morbidity with the laryngeal mask airway: a comparison of high versus low initial cuff volume. AU - Brimacombe,J, AU - Holyoake,L, AU - Keller,C, AU - Barry,J, AU - Mecklem,D, AU - Blinco,A, AU - Weidmann,K, PY - 2000/4/26/pubmed PY - 2000/5/16/medline PY - 2000/4/26/entrez SP - 338 EP - 43 JF - Anaesthesia JO - Anaesthesia VL - 55 IS - 4 N2 - In this study we tested the hypothesis that the initial cuff volume of the laryngeal mask airway influences emergence characteristics and postoperative laryngopharyngeal morbidity. One hundred and sixty adult patients undergoing minor surgery were randomly assigned for airway management with the laryngeal mask airway with either a fully inflated cuff (LMA-High) or a semi-inflated cuff (LMA-Low). Anaesthesia was with propofol, nitrous oxide, oxygen and isoflurane. Following insertion, the cuff was inflated with either 15 or 30 ml for the size 4 (females) and 20 or 40 ml for the size 5 (males). At the end of surgery, a blinded observer documented the presence or absence of adverse airway events (hypoxia, hypercapnea, coughing, retching, regurgitation/vomiting, airway obstruction, hypoventilation, hiccupping, biting, body movement or shivering) during every 1 min epoch and cardiorespiratory variables (heart rate, mean blood pressure, arterial oxygen saturation, end-tidal carbon dioxide and respiratory rate) every 5 min until the patient was awake and the laryngeal mask airway removed. Patients were interviewed about pharyngolaryngeal morbidity (sore throat, dysphonia and dysphagia) immediately before leaving the postanaesthesia care unit and 18-24 h following surgery. Analysis by epoch showed more partial airway obstruction in the LMA-High group, but analysis by patient numbers revealed no difference. Heart rate was slightly higher in the LMA-High group upon arrival in the postanaesthesia care unit, but otherwise there were no differences in cardiorespiratory responses. Sore throat and dysphagia were more common in the LMA-High group. We conclude that, in general, emergence characteristics with the laryngeal mask airway are not influenced by the volume of air used to inflate the cuff, but that postoperative sore throat and dysphagia are more likely at high initial cuff volumes. SN - 0003-2409 UR - https://www.unboundmedicine.com/medline/citation/10781119/Emergence_characteristics_and_postoperative_laryngopharyngeal_morbidity_with_the_laryngeal_mask_airway:_a_comparison_of_high_versus_low_initial_cuff_volume_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0003-2409&date=2000&volume=55&issue=4&spage=338 DB - PRIME DP - Unbound Medicine ER -