A comparison of usage of the laryngeal mask UniqueTM in denticulate and edentulate geriatric patients.

BACKGROUND/AIM: Mask ventilation in geriatric and edentulous patients can be ineffective or even impossible because of the shape inside the patients' cheeks. For patients for whom a mask cannot be used for long, the use of a laryngeal mask can ease the administration of anesthesia. The aim of this study was to compare the use of the laryngeal mask UniqueTM in denticulate and edentulate patients aged over 65 years. MATERIALS AND METHODS: This prospective study included patients according to the American Society of Anesthesiologists I-III classification, aged 65 years or more. The patients were divided into two groups: a dentulous group (n = 33) and an edentulous group (n = 33). The success of the first attempt of insertion, ease of insertion, time taken to insert, and oropharyngeal leak pressure were measured. After insertion of the laryngeal mask UniqueTM, a researcher who was unaware of whether the patients had teeth or not conducted an oropharyngeal leak test. RESULTS: The success rate of inserting the laryngeal mask UniqueTM on the first attempt was higher in the dentulous group than in the edentulous group. Ease of insertion, time taken to insert, oropharyngeal leak pressure, and laryngopharyngeal morbidity were similar for each group. CONCLUSION: In this study, successful insertion of the laryngeal mask UniqueTM was higher in dentulous than in edentulous patients. We conclude that this effect could have important implications for anesthesiologists managing edentulous geriatric patients with supraglottic airway devices.

Comparison of Laryngeal Mask Airway Supreme(TM) Versus Unique(TM) in Edentulous Geriatric Patients.

OBJECTIVE: It is more difficult to perform bag-mask ventilation in edentulous patients than in patients with intact dentition. The laryngeal mask airway (LMA) provides a better alternative to the standard face mask if the facial contours of the patient are not suited for the standard face mask. We aimed to compare these two different LMAs in edentulous geriatric patients. METHODS: Edentulous patients aged ≥65 years of American Society of Anesthesiologists physical status I-III were included in the study. They were randomly assigned to Supreme group (n=30) and Unique group (n=30). Success of first insertion attempt, ease and time of insertion and oropharyngeal leak pressure were recorded. RESULTS: The success rate of the first insertion attempt was higher in the Supreme group than in the Unique group (86.6 and 73.3%, respectively; p=0.04). Time of insertion was similar (10.04 s and 11.87 s, respectively) and insertion was easy in 90% and 100% of patients, respectively. Oropharyngeal leak pressures were measured as 20.56-cm H2O and 17.10-cm H2O for LMA Supreme™ and LMA Unique™, respectively. CONCLUSION: The efficacy and safety in both groups were comparable in edentulous geriatric patients during short surgical procedures. Even the success rate of insertion with both was lower than that mentioned in the literature; the success of insertion at the first attempt was superior with the LMA Supreme™ in our edentulous study group.