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A comparison of various supraglottic airway devices for fiberoptical guided tracheal intubation.
Braz J Anesthesiol. 2017 Mar - Apr; 67(2):166-171.BJ

Abstract

BACKGROUND

Fiberoptical assisted intubation via placed supraglottic airway devices has been described as safe and easy procedure to manage difficult airways. However visualization of the glottis aperture is essential for fiberoptical assisted intubation. Various different supraglottic airway devices are commercially available and might offer different conditions for fiberoptical assisted intubation. The aim of this study was to compare the best obtainable view of the glottic aperture using different supraglottic airway devices.

METHODS

With approval of the local ethics committee 52 adult patients undergoing elective anesthesia were randomly assigned to a supraglottic airway device (Laryngeal Tube, Laryngeal Mask Airway I-Gel, Laryngeal Mask Airway Unique, Laryngeal Mask Airway Supreme, Laryngeal Mask Airway Aura-once). After standardized induction of anesthesia the supraglottic airway device was placed according to the manufacturers recommendations. After successful ventilation the position of the supraglottic airway device in regard to the glottic opening was examined with a flexible fiberscope. A fully or partially visible glottic aperture was considered as suitable for fiberoptical assisted intubation. Suitability for fiberoptical assisted intubation was compared between the groups (H-test, U-test; p<0.05).

RESULTS

Demographic data was not different between the groups. Placement of the supraglottic airway device and adequate ventilation was successful in all attempts. Glottic view suitable for fiberoptical assisted intubation differed between the devices ranging from 40% for the laringeal tube (LT), 66% for the laryngeal mask airway Supreme, 70% for the Laryngeal Mask Airway I-Gel and 90% for both the Laryngeal Mask Airway Unique and the Laryngeal Mask Airway Aura-once.

CONCLUSION

None of the used supraglottic airway devices offered a full or partial glottic view in all cases. However the Laryngeal Mask Airway Unique and the Laryngeal Mask Airway Aura-once seem to be more suitable for fiberoptical assisted intubation compared to other devices.

Authors+Show Affiliations

Universitätsklinikum Regensburg, Klinik für Anästhesiologie, Regensburg, Germany. Electronic address: tom.metterlein@gmx.net.Universitätsklinikum Regensburg, Klinik für Anästhesiologie, Regensburg, Germany.Universitätsklinikum Regensburg, Klinik für Anästhesiologie, Regensburg, Germany.Universitätsklinikum Regensburg, Klinik für Anästhesiologie, Regensburg, Germany.Universitätsklinikum Regensburg, Klinik für Anästhesiologie, Regensburg, Germany.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28236864

Citation

Metterlein, Thomas, et al. "A Comparison of Various Supraglottic Airway Devices for Fiberoptical Guided Tracheal Intubation." Brazilian Journal of Anesthesiology (Elsevier), vol. 67, no. 2, 2017, pp. 166-171.
Metterlein T, Dintenfelder A, Plank C, et al. A comparison of various supraglottic airway devices for fiberoptical guided tracheal intubation. Braz J Anesthesiol. 2017;67(2):166-171.
Metterlein, T., Dintenfelder, A., Plank, C., Graf, B., & Roth, G. (2017). A comparison of various supraglottic airway devices for fiberoptical guided tracheal intubation. Brazilian Journal of Anesthesiology (Elsevier), 67(2), 166-171. https://doi.org/10.1016/j.bjane.2015.09.007
Metterlein T, et al. A Comparison of Various Supraglottic Airway Devices for Fiberoptical Guided Tracheal Intubation. Braz J Anesthesiol. 2017 Mar - Apr;67(2):166-171. PubMed PMID: 28236864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of various supraglottic airway devices for fiberoptical guided tracheal intubation. AU - Metterlein,Thomas, AU - Dintenfelder,Anna, AU - Plank,Christoph, AU - Graf,Bernhard, AU - Roth,Gabriel, Y1 - 2016/05/26/ PY - 2015/07/17/received PY - 2015/09/22/accepted PY - 2017/2/27/entrez PY - 2017/2/27/pubmed PY - 2017/7/8/medline KW - Difficult airway KW - Dispositivo supraglótico KW - Fibreoptic intubation KW - Intubação guiada por fibra óptica KW - Supraglottic airway device KW - Via aérea difícil SP - 166 EP - 171 JF - Brazilian journal of anesthesiology (Elsevier) JO - Braz J Anesthesiol VL - 67 IS - 2 N2 - BACKGROUND: Fiberoptical assisted intubation via placed supraglottic airway devices has been described as safe and easy procedure to manage difficult airways. However visualization of the glottis aperture is essential for fiberoptical assisted intubation. Various different supraglottic airway devices are commercially available and might offer different conditions for fiberoptical assisted intubation. The aim of this study was to compare the best obtainable view of the glottic aperture using different supraglottic airway devices. METHODS: With approval of the local ethics committee 52 adult patients undergoing elective anesthesia were randomly assigned to a supraglottic airway device (Laryngeal Tube, Laryngeal Mask Airway I-Gel, Laryngeal Mask Airway Unique, Laryngeal Mask Airway Supreme, Laryngeal Mask Airway Aura-once). After standardized induction of anesthesia the supraglottic airway device was placed according to the manufacturers recommendations. After successful ventilation the position of the supraglottic airway device in regard to the glottic opening was examined with a flexible fiberscope. A fully or partially visible glottic aperture was considered as suitable for fiberoptical assisted intubation. Suitability for fiberoptical assisted intubation was compared between the groups (H-test, U-test; p<0.05). RESULTS: Demographic data was not different between the groups. Placement of the supraglottic airway device and adequate ventilation was successful in all attempts. Glottic view suitable for fiberoptical assisted intubation differed between the devices ranging from 40% for the laringeal tube (LT), 66% for the laryngeal mask airway Supreme, 70% for the Laryngeal Mask Airway I-Gel and 90% for both the Laryngeal Mask Airway Unique and the Laryngeal Mask Airway Aura-once. CONCLUSION: None of the used supraglottic airway devices offered a full or partial glottic view in all cases. However the Laryngeal Mask Airway Unique and the Laryngeal Mask Airway Aura-once seem to be more suitable for fiberoptical assisted intubation compared to other devices. SN - 0104-0014 UR - https://www.unboundmedicine.com/medline/citation/28236864/A_comparison_of_various_supraglottic_airway_devices_for_fiberoptical_guided_tracheal_intubation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0104-0014(16)30060-4 DB - PRIME DP - Unbound Medicine ER -