Ramli, Wan Marzuki Wan
(2006)
A comparison for ease of insertion and adequacy of ventilation between laryngeal tube suctioning (LTS) and airway management device (AMD).
Masters thesis, Universiti Sains Malaysia.
Abstract
The purpose of the study is to assess whether the recently introduced modified version
of the airway management device (AMD) is easy, reliable, and safe as claims by the
manufacturer. We compared the use the airway management device (AMD) with the
laryngeal tube suctioning (L TS) in spontaneously ventilating adult patient undergoing
general anaesthesia. Ease of insertion, the effectiveness of ventilation and incidence of
airway complication when using the tube for airway maintenance were evaluated
between the two groups.
A randomized single blinded prospective study was conducted involving a total of 80
patients premedicated, ASA I or II patients, aged 18 to 65 years and were divided into 2
groups either L TS or AMD as for airway management during elective surgery After a
standardized induction of anaesthesia with intravenous fentanyl 1.5 mcg.kg-1 and
intravenous propofol 2 mg.kg-1
, a size 3 or 4 LTS or AMD was inserted and the patients
breathed spontaneously throughout the surgery with no muscle relaxant given.
Anaesthesia was maintained with nitrous oxide, oxygen and isoflurane. The airway
device was removed at the end of surgery with the patients fully awake. The ease of
insertion (easy: require one attempt; difficult: require 2 or 3 attempts; or failed), the rate
of successful insertion and the incidence of airway trauma were recorded. Episodes of
airway manipulations and desaturation intraoperatively were also recorded.
We were able to achieve a clear airway in 36 patients (90.0%) in the LTS group and in
38 patients (95%) in the AMD group. In the L TS group, the LTS was considered easy
to insert in 25 patients, difficult in 11 patients, and it was easy in 33 patients, difficult in
5 patients in the AMD group. The ease of insertion and success rates of insertion
between the two groups were not significantly different (p=O.l56 and 0.338
respectively). There was no significant difference in the incidence and severity of the
postoperative airway complications between the two groups. Although, the incidence of
airway manipulation and desaturation were higher in AMD compared to the LTS but it
is not likely to be clinically relevant in this study. We conclude that L TS and AMD
performed equally well in the ease of insertion and atraumatic to the airway.
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