Comparison of Five 2nd-generation Supraglottic Airway Devices for Airway Management Performed by Novice Military Operators

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2015 Oct 24

PMID 26495289

Citations 13

Authors

Tomas Henlin

Michal Sotak

Petr Kovaricek

Tomas Tyll

Lukas Balcarek

Pavel Michalek

Affiliations

Soon will be listed here.

Abstract

Objectives: Five different second-generation supraglottic airway devices, ProSeal LMA, Supreme LMA, i-gel, SLIPA, and Laryngeal Tube Suction-D, were studied. Operators were inexperienced users with a military background, combat lifesavers, nurses, and physicians.

Methods: This was a prospective, randomized, single-blinded study. Devices were inserted in the operating room in low light conditions after induction of general anesthesia. Primary outcome was successful insertion on the first attempt while secondary aims were insertion time, number of attempts, oropharyngeal seal pressure, ease of insertion, fibre optic position of device, efficacy of ventilation, and intraoperative trauma or regurgitation of gastric contents.

Results: In total, 505 patients were studied. First-attempt insertion success rate was higher in the Supreme LMA (96%), i-gel (87.9%), and ProSeal LMA (85.9%) groups than in the Laryngeal Tube Suction-D (80.6%) and SLIPA (69.4%) groups. Insertion time was shortest in the Supreme LMA (70.4 ± 32.5 s) and i-gel (74.4 ± 41.1 s) groups (p < 0.001). Oropharyngeal seal pressures were higher in the Laryngeal Tube Suction-D and ProSeal LMA groups than in other three devices.

Conclusions: Most study parameters for the Supreme LMA and i-gel were found to be superior to the other three tested supraglottic airway devices when inserted by novice military operators.

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References

Tiefenthaler W, Eschertzhuber S, Brimacombe J, Fricke E, Keller C, Kaufmann M . A randomised, non-crossover study of the GuardianCPV Laryngeal Mask versus the LMA Supreme in paralysed, anaesthetised female patients. Anaesthesia. 2013; 68(6):600-4. DOI: 10.1111/anae.12178. View

Combes X, Jabre P, Jbeili C, Leroux B, Bastuji-Garin S, Margenet A . Prehospital standardization of medical airway management: incidence and risk factors of difficult airway. Acad Emerg Med. 2006; 13(8):828-34. DOI: 10.1197/j.aem.2006.02.016. View

Schalk R, Byhahn C, Fausel F, Egner A, Oberndorfer D, Walcher F . Out-of-hospital airway management by paramedics and emergency physicians using laryngeal tubes. Resuscitation. 2009; 81(3):323-6. DOI: 10.1016/j.resuscitation.2009.11.007. View

Oh S, Lim B, Kim H, Lim S . Comparison of the clinical effectiveness between the streamlined liner of pharyngeal airway (SLIPA) and the laryngeal mask airway by novice personnel. Korean J Anesthesiol. 2012; 63(2):136-41. PMC: 3427806. DOI: 10.4097/kjae.2012.63.2.136. View

Michalek P, Hodgkinson P, Donaldson W . Fiberoptic intubation through an I-gel supraglottic airway in two patients with predicted difficult airway and intellectual disability. Anesth Analg. 2008; 106(5):1501-4, table of contents. DOI: 10.1213/ane.0b013e31816f22f6. View

Nolan J, Soar J, Zideman D, Biarent D, Bossaert L, Deakin C . European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary. Resuscitation. 2010; 81(10):1219-76. DOI: 10.1016/j.resuscitation.2010.08.021. View

Cook T, Woodall N, Frerk C . Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011; 106(5):617-31. DOI: 10.1093/bja/aer058. View

Kikuchi T, Kamiya Y, Ohtsuka T, Miki T, Goto T . Randomized prospective study comparing the laryngeal tube suction II with the ProSeal laryngeal mask airway in anesthetized and paralyzed patients. Anesthesiology. 2008; 109(1):54-60. DOI: 10.1097/ALN.0b013e318178819b. View

Chloros T, Xanthos T, Iacovidou N, Bassiakou E . Supreme Laryngeal Mask Airway achieves faster insertion times than Classic LMA during chest compressions in manikins. Am J Emerg Med. 2013; 32(2):156-9. DOI: 10.1016/j.ajem.2013.10.048. View

10.

Coulson A, Brimacombe J, Keller C, Wiseman L, Ingham T, Cheung D . A comparison of the ProSeal and classic laryngeal mask airways for airway management by inexperienced personnel after manikin-only training. Anaesth Intensive Care. 2003; 31(3):286-9. DOI: 10.1177/0310057X0303100308. View

11.

Schalk R, Meininger D, Ruesseler M, Oberndorfer D, Walcher F, Zacharowski K . Emergency airway management in trauma patients using laryngeal tube suction. Prehosp Emerg Care. 2011; 15(3):347-50. DOI: 10.3109/10903127.2011.561405. View

12.

Ruetzler K, Roessler B, Potura L, Priemayr A, Robak O, Schuster E . Performance and skill retention of intubation by paramedics using seven different airway devices--a manikin study. Resuscitation. 2011; 82(5):593-7. DOI: 10.1016/j.resuscitation.2011.01.008. View

13.

Michalek P, Jindrova B, Kriz P, Stritesky M, Sedlar M . A pilot evaluation of the 3gLM-R - A new supraglottic airway device. Adv Med Sci. 2015; 60(2):186-90. DOI: 10.1016/j.advms.2015.02.001. View

14.

Keller C, Brimacombe J, 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. View

15.

Ragazzi R, Finessi L, Farinelli I, Alvisi R, Volta C . LMA Supreme™ vs i-gel™--a comparison of insertion success in novices. Anaesthesia. 2012; 67(4):384-8. DOI: 10.1111/j.1365-2044.2011.07002.x. View

16.

Choi Y, Cha S, Kang H, Baek C, Jung Y, Woo Y . The clinical effectiveness of the streamlined liner of pharyngeal airway (SLIPA) compared with the laryngeal mask airway ProSeal during general anesthesia. Korean J Anesthesiol. 2010; 58(5):450-7. PMC: 2881520. DOI: 10.4097/kjae.2010.58.5.450. View

17.

Howes B, Wharton N, Gibbison B, Cook T . LMA Supreme insertion by novices in manikins and patients. Anaesthesia. 2010; 65(4):343-7. DOI: 10.1111/j.1365-2044.2010.06262.x. View

18.

Wharton N, Gibbison B, Gabbott D, Haslam G, Muchatuta N, Cook T . I-gel insertion by novices in manikins and patients. Anaesthesia. 2008; 63(9):991-5. DOI: 10.1111/j.1365-2044.2008.05542.x. View

19.

Miller D, Light D . Laboratory and clinical comparisons of the Streamlined Liner of the Pharynx Airway (SLIPA) with the laryngeal mask airway. Anaesthesia. 2003; 58(2):136-42. DOI: 10.1046/j.1365-2044.2003.02962.x. View

20.

Teoh W, Lee K, Suhitharan T, Yahaya Z, Teo M, Sia A . Comparison of the LMA Supreme vs the i-gel in paralysed patients undergoing gynaecological laparoscopic surgery with controlled ventilation. Anaesthesia. 2010; 65(12):1173-9. DOI: 10.1111/j.1365-2044.2010.06534.x. View