LMA Placement Techniques and Airway in Children and Oropharyngeal Leak Pressure
- Conditions
- AnesthesiaAirway
- Interventions
- Procedure: Group 2Procedure: Group 1Procedure: Group 3
- Registration Number
- NCT06174896
- Lead Sponsor
- Ondokuz Mayıs University
- Brief Summary
Our study aimed to compare the manual placement, direct laryngoscopy and video laryngoscopy assisted placement techniques of LMA Proseal, a new generation laryngeal mask (LMA), and to find an effective placement technique that does not allow airway leakage in one go.
- Detailed Description
LMA is an airway device frequently used in pediatric anesthesia. It is preferred for short interventions because it is less invasive compared to intubation. However, problems such as not being fully seated, slipping, and leakage can be encountered during placement. Multiple attempts after unsuccessful placement may cause undesirable results such as edema and sore throat. The aim in this study is to reveal the most accurate placement technique and to transfer this method to clinical applications.
Our research is a prospective, randomized controlled method study.
Patients will be divided into 3 groups.
Group 1:(Standard technique)
Group 2:(Placement with direct laryngoscopy)
Group 3:(Placement with the aid of video laryngoscopy)
After LMA Proseal placement, airway sealing pressures will be measured with appropriate technique. Airway tightness pressure measurement will be made with the technique accepted in the literature through the sensors in the anesthesia machine.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 150
- 1-10 years old
- Between 5-40 kg
- ASA (American Society of Anesthesiologists) physical score I/II
- Cases undergoing elective surgery lasting less than 90 minutes
- Patients who are expected to have a difficult airway
- Those with potential regurgitation risk (severe GER, presence of hiatal hernia)
- Those who will undergo head and neck surgery, laparoscopic surgery
- Those who will undergo surgery in the prone position
- Emergency surgical interventions
- Those who need muscle relaxants
- Presence of intraoral abscess, pharyngeal pathology
- Those who have had an upper or lower respiratory tract infection in the last 4 weeks
- History of allergy to the drugs to be used
- Failure of patients and their relatives to give consent
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Group 2 Group 2 Placement with direct laryngoscopy Group 1 Group 1 Placement with standard technique Group 3 Group 3 Placement with the aid of video laryngoscopy
- Primary Outcome Measures
Name Time Method Oropharyngeal leak pressure within 2-3 minutes after laryngeal mask insertion before start of surgery Oropharyngeal leak pressure (OLP) will be measured by closing the adjustable pressure limiting valve on the anesthesia machine. The fresh gas flow was adjusted to 3 L/min. When the APL (Adjustable pressure limiting) valve was closed and manually ventilated. The leak sound that occurs during ventilation will be auscultated. The first peak airway pressure at which the leak occurs will be recorded as the oropharyngeal leak pressure.
After successful insertion, lma proseal location will be evaluated with fiberoptic imaging.
- Secondary Outcome Measures
Name Time Method Need for optimization maneuvers intraoperative period It will be recorded whether additional maneuvering is performed for optimal placement. LMA rotation, jaw thrust, head extension, and flexion will be use as optimization maneuvers.
Blood pressure Preoperatively, one minute after the induction, fifth minute and before removed laryngeal mask. Measure blood pressure in millimeter of mercury by non-invasive blood pressure.
İnsertion time intraoperative period LMA insertion time (time from LMA handling to first wave formation in capnography)
Number of placement attempts intraoperative period The number of attempts for optimal placement will be recorded
Peripheral oxygen saturation Preoperatively, one minute after the induction, fifth minute and before removed laryngeal mask. Measure peripheral oxygen saturation per minute by pulse oximeter.
Complications intraoperative and postoperative day 1. İnvestigate the existence of complications that may be encountered in the routine after LMA placement and removal.
Heart rate Preoperatively, one minute after the induction, fifth minute and before removed laryngeal mask. Measure heart rate in beats per minute by electrocardiography monitor.
Trial Locations
- Locations (1)
Ondokuz Mayis University
🇹🇷Samsun, Turkey