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The laryngeal mask airway LMA and laryngealube suction-disposable (LTS-D) is the second generation single-use supraglottic airway devices (SADs) with gastric access that are used for management of airway during general anaesthesia in spontaneously and mechanically ventilated patients.
The results of the study conclude that both LMA and LTS-D
are suitable and useful for airway treatment in patients breathing
spontaneously during general anaesthesia for minor surgery of short
duration.
The laryngeal mask airway LMA and laryngealube suction-disposable (LTS-D) is the second generation single-use supraglottic airway devices (SADs) with gastric access that are used for management of airway during general anaesthesia in spontaneously and mechanically ventilated patients. A comparison has been made between LMA and Proseal laryngeal mask airway (PLMA) and the LTS-II during mechanical and spontaneous ventilation. In recent studies, the LTS-D has been compared with LMA when used by essential life support trained nurses and during pressure controlled mechanical ventilation.
The LMA and the LTS-D were compared with respect to oxygenation saturation (SpO2) and end-tidal CO2(ETCO2), time to achieve an adequate airway, ease of insertion, need for interventions to optimise ventilation, cuff-leak pressure, ventilatory variables, fiberoptic score, and adverse perioperative events.
Rationale behind research:
The data comparing LMA with the LTS-D during spontaneous ventilation was not available. The hypothesis was that despite differences in their structural design, the LMA and LTS-D have similar performances in patients breathing spontaneously during general anaesthesia.
Objective:
This randomized study was aimed to compare the LMA and the LTS-D with respect to oxygenation saturation (SpO2) and end-tidal CO2(ETCO2), time to achieve an adequate airway, ease of insertion, need for interventions to optimize ventilation, cuff-leak pressure, ventilatory variables, fiberoptic score, and adverse perioperative events.
Study outcomes:
Time Points: NA
Outcomes
Study outcomes:
The results of the study indicated that LMA and the LTS-D
are equally useful for airway management, in patients breathing spontaneously
during general anaesthesia of short duration. There were statistically
significant differences observed in the SpO2, but not clinically
significant. The ETCO2 concentrations were not differentiated. The
minimal hypercapnia lies within the acceptable values that occurred with both
SADs during natural ventilation. No statistical differences observed between
the two groups regarding the inspiratory and expiratory minute volume. Also, no
differences observed in the complication rate between both the groups in the
incidence of device blood staining, sore throat, and hoarseness, suggesting
that both SADs are similar regarding airway trauma. The techniques for
insertion of both the LTS-D and LMA were observed to be different but straightforward.
It was found that in LTS-D group more jaw thrust maneuvers was necessitated to
achieve an adequate airway. There are structural and anatomical differences in
the designs, but the ventilatory performances of both devices were similar.
The LMA and the LTS-D devices are useful in airway
management of spontaneously breathing patients undergoing general anaesthesia
for a short duration of minor elective surgery with a low rate of
complications.
Somri M et al. J Anaesthesiol Clin Pharmacol 2018;34:182-7
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