COMPARATIVE STUDY BETWEEN THREE EXTRA-GLOTTIC AIRWAY DEVICES WITH GASTRIC ACCESS IN GENERAL SURGERY

Background: Extraglottic airway devices (EGADs)synonyms may be supraglottic airway devices (SADs, SGAs) or supra-laryngeal airways (SLA), are an integral part of modern anesthetic practice.These devices are inserted into the oral cavity after induction to anesthesia and help to provide patent airways during surgery.Objective: To compare the efficacy of three extra-glottic airway devices with gastric access tube namely: Proseal LMA, Air-Q, and Baska Mask in providing an adequate airway seal for general surgery in paralyzed patients with apparent normal airways, receiving controlled ventilation. Patients and Methods:This study was carried out in Al-Azhar University Hospitals, designed prospective, randomized, single-blinded study, included 90 adult male and female patients with ASA physical status class I or II, aged 18 -44 years who were scheduled to have elective surgeries under general anesthesia constituted the population of the present study.Inclusion criteria of this study obtained after approval of the Anesthesia Department's Research/Ethics Committee and written informed consents were obtained from the patients.Results: As regard EGAD insertion, there were no cases of failed insertion of all airway devices.The Baska Mask was the easiest device to be inserted, while the PLMA was easier than Air Q.Both Baska Mask and PLMA showed a higher rate of insertion from first attempt than Air Q.The study showed that there was no need for repositioning or any manipulations of the device for optimization of ventilation in the Baska Mask group, while there was a need for optimizing the position in 6.7% and 13.3% in PLMA and Air Q groups, respectively.The duration of insertion in the Baska Mask group was the shortest among the three groups with significant difference compared with other two groups.The duration of insertion in PLMA group was shorter than Air Q group.Suprasternal notch test was done in both Baska Mask and PLMA groups only as the tip of NGT channel did not reach esophagus in the Air-Q group.There was a significant difference between PLMA and Baska Mask Groups (p =0.00).The test was negative in 1 patient (3.3%) in PMLA group in contrast to 2 patients in Baska Mask group (6.7%).There was no major complication in all patients in all groups.There was neither vomiting nor hoarseness of voice in all groups.There was no displacement of any device in the Baska Mask group.In both Air Q and PLMA groups displacement occurred in (3.3%) of devices.The devices that stained with bloody sputum were (23.3%), (26.7%) and (6.7%) of devices in PLMA, Air Q, and Baska Mask groups, respectively.The patients who complained of sore throat after recovery were (16.7%), (23.3%) and (6.7%) in PLMA, Air Q, and Baska Mask groups, respectively. Conclusion:Baska Mask was the easiest device to be inserted as it has the least insertion trials.PLMA was easier in insertion than the Air-Q as it has less insertion trials.Air-Q has the best glottic view through the FOB and higher seal pressure than Baska Mask.

Topic: Airway Management and Intubation Techniques
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences