Anju Bhalotra, Reema Wadhawa, Anisha Singh, Vanya Chugh

ILMA ve Air-Q Laringeal Airway’i Değerlendiren ve Karşılaştıran Prospektif Randomize çalışma

Amaç: Amacımız; birincil hava yolu aracı ve trakeal entübasyon için konduit olarak Air-Q entübasyon laringeal airwayi (ILA) değerlendirmek ve şu anda ‘altın standart’ supraglottik hava yolu olarak kullanılan entübasyon laringeal maske airway (ILMA) ile karşılaştırmaktır. Yöntem: Elektif cerrahi planlanan 18-60 yaşları arasındaki her iki cinsiyetten 80 hasta iki gruba ayrıldı. Grup I’de (n=40) hava yolu güvenliğini sağlamak için entübasyon laringeal maske airway ve Grup A’da (n=40) Air-Q entübasyon laryngeal airway kullanıldı. Daha sonra her iki araç karşılaştırıldı ve ventilasyon aracı ve entübasyon konduiti olarak değerlendirildi. Bulgular: ILMA (%95), ILA’ya (%72.5) kıyasla daha yüksek ilk deneme entübasyon başarı oranına sahipti, ancak her iki araç da yerleştirme kolaylığı ve entübasyon için gereken toplam süre açısından benzerdi. Sonuç: Hem ILMA hem de ILA, birincil hava yolu araçları olarak benzerdi. İlk denemede kör entübasyon başarı oranı Grup I’de anlamlı olarak daha yüksekti.

A Prospective Randomized Study to Evaluate and Compare ILMA and Air-Q Intubating Laryngeal Airway

Objective: Our aim was to evaluate the Air-Q intubating laryngeal airway (ILA) as a primary airway device and conduit for tracheal intubation and to compare it with the intubating laryngeal mask airway (ILMA) which is currently the ‘gold standard’ supraglottic airway used as a conduit for tracheal intubation. Methods: Eighty patients of either sex, aged 18-60 years scheduled for elective surgery were allocated into two groups. In Group I (n=40), the intubating laryngeal mask airway was used to secure the airway and in Group A (n=40), the Air-Q intubating laryngeal airway was used. Both devices were then compared and assessed as ventilation device and intubation conduit. Results: ILMA had a higher first attempt intubation success rate (95%) as compared to ILA (72.5%) but both devices were comparable with respect to ease of placement and total time required for intubation. Conclusion: Both ILMA and ILA were comparable as primary airway devices. The first attempt blind intubation success rate was significantly higher in Group I.

PDF

___

1. Brain AI, Verghese C, Addy EV, Kapila A, Brimacombe J. The intubating laryngeal mask. 315 II: a preliminary clinical report of a new means of intubating the trachea. Br J Anaesth. 1997;79:704-9. https://doi.org/10.1093/bja/79.6.704
2. Bakker EJ, Valkenburg M, Galvin EM. Pilot study of the air-Q intubating laryngeal airway in clinical use. Anaesthesia and intensive care. 2010;38:346-8. https://doi.org/10.1177/0310057X1003800217
3. Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia. 320 1984;39:1105-11. https://doi.org/10.1111/j.1365-2044.1984.tb08932.x
4. Klein MT, Jones J. Utility of the Intubating Laryngeal Airway®: report of an observational study. Anesthesiology. 2005;103:A846.
5. Danha RF, Thompson JL, Popat MT, Pandit JJ. Comparison of fibreoptic‐guided orotracheal intubation through classic and single‐use laryngeal mask airways. Anaesthesia. 2005;60:184-8. https://doi.org/10.1111/j.1365-2044.2004.04045.x
6. Ferson DZ, Rosenblatt WH, Johansen MJ, Osborn I, Ovassapian A. Use of the intubating LMA-Fastrach™ in 254 patients with difficult-to-manage airways. Anesthesiology. 2001;95:1175-81. https://doi.org/10.1097/00000542-200111000-00022
7. Baskett PJ, Parr M, Nolan JP. The intubating laryngeal maskResults of a multicentre trial 330 with experience of 500 cases. Anaesthesia. 1998;53:1174-9. https://doi.org/10.1046/j.1365-2044.1998.00614.x
8. Neoh EU, Choy YC. Comparison of the air-Q ILA™ and the LMA-Fastrach™ in airway management during general anaesthesia. SAJAA. 2012;18:150-5. https://doi.org/10.1080/22201173.2012.10872844
9. Joo HS, Rose DK. The intubating laryngeal mask airway with and without fiberoptic guidance. Anesth Analg. 1999;88:662-6. https://doi.org/10.1097/00000539-199903000-00036
10. Karim YM, Swanson DE. Comparison of blind tracheal intubation through the intubating laryngeal mask airway (LMA FastrachTM) and the Air‐QTM. Anaesthesia. 2011;66:185-90. https://doi.org/10.1111/j.1365-2044.2011.06625.x
11. Malhotra SK, Bharath KV, Saini V. Comparison of success rate of intubation through air-Q with ILMA using two different endotracheal tubes. Indian J Anaesth. 2016;60:242-7. https://doi.org/10.4103/0019-5049.179448
12. Abdel-Halim TM, El Enin MA, Elgoushi MM, Afifi MG, Atwa HS. Comparative study between Air-Q and Intubating Laryngeal Mask Airway when used as conduit for fiber-optic. Egypt. J. Anaesth. 2014;30:107- 13. https://doi.org/10.1016/j.egja.2013.10.004
13. Panjwani S, Seymour P, Pandit JJ. A manoeuvre for using the flexilbe fibreoptic bronchoscope through the Intubating Laryngeal Mask Airway®. Anaesthesia. 345 2001;56:696-7. https://doi.org/10.1046/j.1365-2044.2001.02137-9.x
14. Pandit JJ, MacLachlan K, Dravid RM, Popat MT. Comparison of times to achieve tracheal intubation with three techniques using the laryngeal or intubating laryngeal mask airway. Anaesthesia. 2002;57:128-32. https://doi.org/10.1046/j.0003-2409.2001.02401.x
15. Wong DT, Arora G, Apichatibutra N, Lee VY, Venkatraghavan L. Repeated performance of 350 tracheal tube insertion through intubating laryngeal airway on mannequins. J Clin Anesth. 2010;22:619-24. https://doi.org/10.1016/j.jclinane.2010.06.005