ABSTRACT
INTRODUCTION:Management of airway is one of the primary responsibilities of anesthesiologist1.Supraglottic airway devices have become a standard fixture in airway management, filling aniche between the face mask and tracheal tube in terms of both anatomical position anddegree of invasiveness. They have separate gastric channel to reduce regurgitation &pulmonary aspiration2.Proseal LMA has unique double cuff arrangement, main cuff is inflated to seal the laryngealopening and additional pharyngeal cuff helps to improve the airway seal which make thePLMA ideal for positive pressure ventilation. ‘I-gel’ is a non-inflatable supraglottic airwaydevice designed to avoid compression trauma.Objectives of the study were Quality of insertion, Complications duringinsertion, Quality of airway sealing, Analysis of hemodynamic parameters, Postoperative complications.METHODS: Total 60 patients were divided in 2 groups: A & B. Airway secured with I-gel& PLMA respectively.Ease of insertion of devices, airway sealing quality score, ease & number of attempts ofgastric tube insertion were noted.RESULTS: I-gel is better than PLMA in term of faster & easy insertion requiring lessmanipulation with low incidence of complications during insertion, less hemodynamic stressresponse and lower postoperative complications.CONCLUSION: Among the second generation supraglottic airway device I-gel is a better &safe alternative to PLMA during elective surgeries
ABSTRACT
Introduction: Baska mask is a 3rd generation Supraglottic Airway Device (SGA). One of the major limitations of the SGA device is the risk of aspiration. Aim of the study: Evaluate the advantages of Baska mask over Proseal LMA in providing adequate laryngeal seal and ease of insertion. Materials and methods: A Randomized prospective single-blinded study. A study group of 40 female patients recruited and divided into 2 groups. Group I (BM-Baska Mask) with 20 patients and Group II (PLM- Proseal LMA) with 20 patients. All patients received general anesthesia with control ventilation. SGA device insertion was done once patients were anesthetized. Baseline intraoperative hemodynamic parameters and capnography were monitored. The ease of insertion was assessed by a number of attempts, time of insertion and any extra maneuver required. The airway pressure calculated as the plateau pressure with fresh gas flow at 6L and APL valve at 70cm H20. In Proseal LMA it was calculated using a handheld manometer. Results: The success rate of insertion was comparable in 2 groups. The mean time for insertion was 13.3 s while it was 19.7s for PLMA (Pvalue of 0`001). The mean airway sealing pressure was significantly higher in the BM group (p= 0.000). The seal pressure ranged from 20 -29 and 24 -37 in group I and II respectively with P value of 0.001 which makes it significant. There was no significant post-operative laryngopharyngeal morbidity in both groups. Conclusion: Baska mask provides an adequate seal with better ease of insertion when compared to Proseal LMA.
ABSTRACT
The laryngeal mask airway (LMA) is widely used as an adjunctive airway device composed of a tube with a cuffed mask-like projection on the distal end. The LMA is simple to use and less invasive to pharynx and larynx than endotracheal tube. The LMA is inserted blindly into the hypopharynx, forms a low pressure seal around the laryngeal inlet. It is minimally stimulating the airway. Microscopic mucosal injuries are common during laryngeal mask airway (LMA) insertion but macroscopic injuries are rare and few have been reported with the ProSeal LMA. This report describes a case of the tearing of the lingual frenulum incidentally caused by insertion of the ProSeal LMA in a child.