Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T11:47:12.177Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of laryngeal tube with laryngeal mask airway in anaesthetized and paralysed patients

Published online by Cambridge University Press:  01 July 2007

T. S. Yildiz ,
M. Solak  and
K. Toker
T. S. Yildiz*
Affiliation:
University of Kocaeli, School of Medicine, Department of Anaesthesiology, Kocaeli, Turkey
M. Solak
Affiliation:
University of Kocaeli, School of Medicine, Department of Anaesthesiology, Kocaeli, Turkey
K. Toker
Affiliation:
University of Kocaeli, School of Medicine, Department of Anaesthesiology, Kocaeli, Turkey
*
Correspondence to: Tulay Sahin Yildiz, Department of Anaesthesiology, School of Medicine, University of Kocaeli, Derince 41900, Kocaeli, Turkey. E-mails: [email protected], [email protected]; Tel: +90 262 2260573/+90 262 3039499; Fax: +90 262 3257363
Get access

Summary

Background and objective

The laryngeal mask has become a widely accepted alternative to endotracheal intubation and mask ventilation. The laryngeal tube is a relatively new supraglottic airway device for airway management. We compared the new version of the laryngeal tube with the laryngeal mask.

Methods

In a randomized design, either a laryngeal tube (n = 66) or a laryngeal mask (n = 66) were inserted. Ease of insertion, oxygenation and ventilation, spirometry data and postoperative airway morbidity were determined.

Results

After successful insertion, it was possible to maintain oxygenation and ventilation in all the patients. Insertion success rates after the first, second and third attempts were 84.8% (n = 56), 12.1% (n = 8) and 3% (n = 2) for the laryngeal tube compared with 56.1% (n = 37), 25.8% (n = 17) and 18.2% (n = 12) for the laryngeal mask (P = 0.001). There was no significant difference in peak airway pressure, and dynamic compliance between the groups (P > 0.05). Blood on the cuff after removal of the device was noted in one patient with the laryngeal tube and in 10 patients with the laryngeal mask. Six patients in the laryngeal mask group complained of hoarseness (P = 0.012).

Conclusion

With respect to clinical function, the new version of the laryngeal tube and the laryngeal mask are similar and either device can be used to establish a safe and effective airway in paralysed patients.

Keywords

ANAESTHESIA GENERALLARYNGEAL MASKS, laryngeal tubeRESPIRATORY MECHANICSRESPIRATION ARTIFICIAL
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 7 , July 2007 , pp. 620 - 625
Copyright
Copyright © European Society of Anaesthesiology 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Asai, T, Murao, K, Shingu, K. Efficacy of the laryngeal tube during intermittent positive-pressure ventilation. Anaesthesia 2000; 55: 1099–1102.CrossRefGoogle ScholarPubMed
2.Asai, T, Shingu, K. The laryngeal tube (review). Br J Anaesth 2005; 95: 729–736.CrossRefGoogle Scholar
3.Asai, T, Kawashima, A, Hidaka, I. Use of the laryngeal tube in patients without teeth. Resuscitation 2001; 51: 213–214.CrossRefGoogle ScholarPubMed
4.Matioc, AA, Olson, J. Use of the laryngeal tube in two unexpected difficult airway situations: lingular tonsillar hyperplasia and morbid obesity. Can J Anaesth 2004; 51: 1018–1021.CrossRefGoogle Scholar
5.Asai, T. Use of the laryngeal tube for difficult fiberoptic tracheal intubation. Anaesthesia 2005; 60: 826.CrossRefGoogle Scholar
6.Yildiz, TS, Solak, M, Toker, K. The incidence and risk factors of difficult mask ventilation. J Anesth 2005; 19: 7–11.CrossRefGoogle ScholarPubMed
7.Pennant, JH, White, PF. The laryngeal mask airway – its uses in anesthesiology. Anesthesiology 1993; 79: 144–163.Google ScholarPubMed
8.Brain, AIJ, McGhee, TD, McAteer, EJ, Thomas, A, Abu-Saad, MAW, Bushman, JA. The laryngeal mask airway-development and preliminary trials of a new type of airway. Anaesthesia 1985; 40: 356–361.CrossRefGoogle ScholarPubMed
9.Asai, T, Kawashima, A, Hidaka, I, Kawashi, S. The laryngeal tube in comparison with the laryngeal mask: insertion, gas leak and gastric insufflation. Br J Anaesth 2002; 89: 729–732.CrossRefGoogle Scholar
10.Cook, TM, McCormick, B, Asai, T. Randomized comparison of the laryngeal tube and the classic laryngeal mask airway for anaesthesia with controlled ventilation. Br J Anaesth 2003; 91: 373–378.CrossRefGoogle ScholarPubMed
11.Ocker, H, Wenzel, V, Schmucker, P, Steinfath, M, Dörges, V. A comparison of the laryngeal tube with the laryngeal mask airway during routine surgical procedures. Anesth Analg 2002; 95: 1094–1097.Google ScholarPubMed
12.Wrobel, M, Grundmann, U, Wilhelm, W, Wagner, S, Larsen, R. Laryngeal tube versus laryngeal mask airway in anaesthetized non-paralysed patients. A comparison of handling and postoperative morbidity. Anaesthesist 2004; 53: 702–708.Google ScholarPubMed
13.Miller, DM, Youkhana, I, Pearce, AC. The laryngeal mask and VBM laryngeal tube compared during spontaneous ventilation: a pilot study. Eur J Anaesthesiol 2001; 18: 593–598.CrossRefGoogle ScholarPubMed
14.Mallampati, SR, Gatt, SP, Gugino, LD et al. . A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J 1985; 32: 429–434.CrossRefGoogle ScholarPubMed
15.Samsoon, GLT, Young, JRB. Difficult tracheal intubation: a retrospective study. Anaesthesia 1987; 42: 487–490.CrossRefGoogle ScholarPubMed
16.Asai, T, Murao, K, Shingu, K. Efficacy of the laryngeal tube during intermittent positive-pressure ventilation. Anaesthesia 2000; 55: 1099–1102.CrossRefGoogle ScholarPubMed
17.Brimacombe, JR, Brain, AIJ, Berry, AM. The Laryngeal Mask Instruction Manual for Anaesthesia. Henley-on-Thames, UK: Intavent Research Ltd, 1999.Google Scholar
18.Laryngeal Tube LT ®. Instructions for Use. Sulz: VBM Medizintechnik GmbH, 2001.Google Scholar
19.Faul, F, Erdfelder, E. G power: a priory post-hoc and compromise power analysis for MS-Dos computer programme. Version 2.0. Department of Physiology, Bonn University, Bonn, Germany, 1992.Google Scholar
20.Asai, T, Shingu, K. Time-related cuff pressures of the laryngeal tube: with and without the use of nitrous oxide. Anesth Analg 2004; 98: 1803–1806.CrossRefGoogle ScholarPubMed
21.Asai, T, Shingu, K, Cook, T. Use of the laryngeal tube in 100 patients. Acta Anaesthesiol Scand 2003; 47: 828–832.CrossRefGoogle ScholarPubMed
22.Cook, TM, McKinstry, C, Hardy, R. Randomized crossover comparison of the ProSeal laryngeal mask airway with the laryngeal tube during anaesthesia with controlled ventilation. Br J Anaesth 2003; 91: 678–683.CrossRefGoogle ScholarPubMed
23.Turan, A, Kaya, G, Koyuncu, O, Karamanlioglu, B, Pamukȱu, Z. Comparison of the laryngeal mask (LMA) and laryngeal tube (LT) with the new perilaryngeal airway (CobraPLA) in short surgical procedures. Eur J Anaesthesiol 2006; 23: 234–238.CrossRefGoogle Scholar
24.Brimacombe, J, Brain, AIJ, Berry, A. The Laryngeal Mask Airway: Review and Practical Guide. London: WB Saunders Company Ltd, 1997.Google Scholar
25.Asai, T, Howell, K, Koga, K, Morris, S. Appropriate size and inflation of the laryngeal mask airway. Br J Anaesth 1998; 80: 470–474.CrossRefGoogle ScholarPubMed
26.Brimacombe, J, Keller, C. Laryngeal mask airway size selection in males and females: ease of insertion, oropharyngeal leak pressure, pharyngeal mucosal pressures and anatomical position. Br J Anaesth 1999; 82: 703–707.CrossRefGoogle ScholarPubMed
27.Berry, AM, Brimacombe, JR, McManus, KF, Goldblatt, M. An evaluation of the factors influencing selection of the optimal size of laryngeal mask airway in normal adults. Anaesthesia 1998; 53: 565–570.CrossRefGoogle ScholarPubMed
28.Doerges, V, Ocker, H, Wenzel, V, Schmucker, P. The laryngeal tube: a new simple airway device. Anesth Analg 2000; 90: 1220–1223.CrossRefGoogle Scholar
29.Sidaras, G, Hunter, JM. Is it safe to artificially ventilate a paralysed patient through the laryngeal mask? The jury is still out. Br J Anaesth 2001; 86: 749–753.CrossRefGoogle ScholarPubMed
30.Akhtar, TM, Street, MK. Risk of aspiration with the laryngeal mask. Br J Anaesth 1994; 72: 447–450.CrossRefGoogle ScholarPubMed
31.Devitt, JH, Wentsone, R, Noel, AG, O’Donnell, MP. The laryngeal mask airway and positive-pressure ventilation. Anesthesiology 1994; 80: 550–555.CrossRefGoogle ScholarPubMed
32.Weiler, N, Latorre, F, Eberle, B et al. . Respiratory mechanics, gastric insufflation pressure, and air leakage of the laryngeal mask airway. Anesth Analg 1997; 84: 1025–1028.CrossRefGoogle ScholarPubMed
33.Gaitini, LA, Vaida, SJ, Somri, M et al. . An evaluation of the laryngeal tube during general anesthesia using mechanical ventilation. Anesth Analg 2003; 96: 1750–1755.CrossRefGoogle ScholarPubMed
34.Brimacombe, JR. Laryngeal Mask Anesthesia: Principles and Practice, 2nd edn. Philadelphia: Saunders, 2005.Google Scholar