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A Comparison of the Laryngeal Mask Airway (LMA) - Unique and LMA-Supreme in Children

Not Applicable
Completed
Conditions
Laryngeal Mask Airway in Children
Registration Number
NCT01653795
Lead Sponsor
Ann & Robert H Lurie Children's Hospital of Chicago
Brief Summary

The aim of this randomized prospective study is to compare two single-use laryngeal mask airways the LMA Unique and the LMA Supreme, in pediatric patients. The investigators hypothesize that airway leak pressures with the LMA Supreme will be superior to the LMA Unique.

Detailed Description

The goal of this study is to compare the LMA Unique and LMA-Supreme in children undergoing anesthesia. The investigators hypothesize that airway leak pressures with the LMA Supreme will be superior when compared with the LMA Unique at two different standardized intracuff pressures (40 and 60 cm H20). Airway leak pressures will be measured by recording the circuit pressure at which equilibrium is reached. The ease of placement, fiberoptic grade of laryngeal view, feasibility of use, and complications will also be assessed.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
180
Inclusion Criteria
  • Children undergoing general anesthesia using a supraglottic airway device
Exclusion Criteria
  • ASA class IV, V, Emergency procedures
  • active respiratory infection
  • known history of difficult mask ventilation
  • a diagnosis of a congenital syndrome associated with difficult airway management
  • airway abnormalities (e.g., laryngomalacia, subglottic stenosis)
  • active gastrointestinal reflux
  • coagulopathy
  • clinically significant pulmonary disease(s)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Airway Leak PressureParticipants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours

Airway leak pressures will be measured by recording the circuit pressure at which equilibrium is reached when fresh gas flow is delivered at 3L/min when the pressure limiting valve is closed.

Secondary Outcome Measures
NameTimeMethod
Time to secure the airwayParticipants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours

From picking up the airway device to bilateral chest expansion and presence of ETCO2

Number of attempts to place the deviceParticipants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours

Number of attempts needed for successful placement will be recorded (maximum of 3 attempts will be considered as a failure)

Fiberoptic grade of laryngeal viewParticipants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours

The laryngeal alignment through the devices will be graded using an established scoring system

Gastric insufflationParticipants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours

The presence of gastric insufflations will be assessed during leak pressure testing by using epigastric auscultation

Ease of gastric tube placement (only in patients who receive LMA Supreme)Participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours

The ease of gastric placement will be timed and assessed using a subjective scale. The LMA Unique does not contain a gastric port so this outcome will only be assessed in patients who received the LMA Supreme device.

Quality of the airwayParticipants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours

The quality of hands free anesthesia will be assessed during maintenance of anesthesia using a previously described scale

Incidence of device repositioning and/or replacementParticipants will be followed for the duration of anesthesia and after surgery, an average of 24 hours

Intra-operative device repositioning or replacement of the device due to excessive air leak or airway obstruction, as evidenced by an obstructive pattern on the continuous end-tidal carbon dioxide monitor that leads to a decrease in oxygen saturation by pulse oximetry to less than 90%.

Oropharyngolaryngeal morbidity at dischargeParticipants will be followed for the duration of anesthesia and after surgery, an average of 24 hours

Assessed by the subject's response or parents subjective assessment to standardized questions regarding oropharyngeal complaints such as sore throat, jaw pain, neck discomfort.

Oropharyngolaryngeal morbidity at 24 hours post-operativelyMeasured at 24 hours after device placement/study initiation

Assessed by the subject's response or parents subjective assessment to standardized questions regarding oropharyngeal complaints such as sore throat, jaw pain, neck discomfort.

Trial Locations

Locations (1)

Ann & Robert H. Lurie Children's Hospital of Chicago

🇺🇸

Chicago, Illinois, United States

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