LMA-ProSeal insertion by novice doctors as affected by a 90° bend created by an intubating stylet: a randomized clinical trial - 12/10/16
: Assistant Professor, Yu Miyazaki, MD : Assistant Professor, Haruki Kido, MD : Assistant Professor, Toshiaki Minami, MD, PhD : Professor and ChiefAbstract |
Study Objective |
This study aimed to test the hypothesis that insertion of the supraglottic device LMA-ProSeal (ProSeal) by novice doctors in anesthetized patients can be improved by using an intubating stylet to create a 90° bend and that better sealing pressure is achieved.
Design |
Randomized clinical trial.
Setting |
Operating room.
Patients |
Seventy adult patients scheduled for elective surgery under general anesthesia using ProSeal with American Society of Anesthesiologists physical status 1 to 3.
Interventions |
ProSeal were inserted with the 90° bend created by the intubating stylet (90D group, 35 patients) or not (ie, conventional insertion; C group, 35 patients).
Measurements |
The number of attempts to successful insertion, sealing pressure, subjective difficulty of insertion by novice doctors, and postoperative pharyngeal pain or hoarseness were compared between groups.
Main Results |
The total number of insertion attempts for the 90D and control groups were 1 (24 and 8, respectively), 2 (8 and 13), 3 (3 and 9), and failure (0 and 5), respectively, showing significant differences between groups (P<.001). Sealing pressure was significantly higher in the 90D group than in the C group (90D group, 23.3±3.7cm H2O; C group, 19.5±2.6cm H2O; P<.001), and the subjective difficulty of insertion was significantly lower in the 90D group (90D group, 27.3±17.6mm; C group, 55.4±22.8mm; P<.001). The incidence of postoperative pharyngeal pain and hoarseness did not differ significantly between groups.
Conclusions |
Our results suggest that creating a 90° bend using an intubating stylet facilitates ProSeal insertion by novice doctors, as reflected by higher successful insertion rates, higher sealing pressure, and lower subjective difficulty of insertion in anesthetized patients.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The LMA-ProSeal (ProSeal) is a reusable supraglottic airway device with good airway sealing pressure. However, because of its large cuff size, the rate of successful insertion on the first attempt is relatively low, especially for novice doctors. |
• | This study tested the hypothesis that insertion of the supraglottic device ProSeal by novice doctors in anesthetized patients can be improved by using an intubating stylet to create a 90° bend and that better sealing pressure is achieved. |
• | Seventy adult patients were assigned to the group with the 90° bend created by the intubating stylet (90D group, 35 patients) or control group (ie, conventional insertion; C group, 35 patients). |
• | The total number of insertion attempts in 90D group was significantly smaller than in C group. Sealing pressure was significantly higher in the 90D group than in the C group, and the subjective difficulty of insertion was significantly lower in the 90D group. |
• | Creating a 90° bend using an intubating stylet facilitates ProSeal insertion by novice doctors, as reflected by higher successful insertion rates, higher sealing pressure, and lower subjective difficulty of insertion in anesthetized patients. |
Keywords : LMA-ProSeal, 90-degree bend, Novice doctors, Randomized controlled trial
Plan
| ☆ | Disclosures: Conflicts of interest and sources of funding: None to report. Financial support for the study was provided by our institution and department. |
| ☆☆ | Trial registry number: UMIN000016120. |
Vol 34
P. 145-150 - novembre 2016 Retour au numéro
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