Different Ways of Airway Management in Elective Minor Surgeries in Geriatric Patients

Study Overview
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Brief Summary
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different ways of airway management in elective minor surgeries of geriatric patients

Detailed Description
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The investigators will used two different ways of pro-seal laryngeal mask insertion technique (laryngoscopy- guided technique or the standard technique) in elective minor surgeries of geriatric toothless patients. The investigators will record the respiratory dynamics, heartbeat, systolic, diastolic, mean arterial pressures every 5 minutes during surgery. The investigators will record the laryngeal mask insertion time and oropharyngeal leakage pressure. The investigators will evaluate the placement of a laryngeal mask according to young criteria. The development and severity of coughing, retching, laryngospasm, extremity, and head movement during laryngeal mask placement will be recorded. Bloodstains, sore throat, hoarseness will be recorded on the mask that may develop due to laryngeal mask placement. The investigators will use the Briacombe scoring and Campbell category system to assess the position of laryngeal mask airway devices.

Official Title
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Comparison of Airway Placement Conditions and Postoperative Effects of Laryngoscope-guided Laryngeal Mask Placement Methods in Sniffing Position in Geriatric Edentulous Patients

Conditions
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Comparison of Different Laryngeal Mask Wearing Methods

Intervention / Treatment
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* Device: direct laryngoskopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA physical status I or II or III Who were scheduled to minor elective ambulatory surgery (e.g. urology operations) Patients undergoing general anesthesia Those who are planned to wear a laryngeal mask for surgical procedure Exclusion Criteria: patients with full stomach A history of gastric reflux A history of convulsions, cardiovascular or neuromuscular disease Allergies to the study drugs obese (Body mass index (BMI) ≥ 40 kg / m2) suspected difficult airway and hyper-reactive airway disease

Ages Eligible for Study
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Minimum Age: 60 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: proseal laryngeal mask insertion<br>no intervention | |
| Experimental: proseal laryngeal mask insertion with laryngoscope<br>with the help of direct laryngoscopy | Device: direct laryngoskopy<br>* Proseal Laryngeal mask inserted with direct laryngoskopy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| laryngeal mask placement | To evaluate the best fiberoptic bronchoscopic view while insertion of pro-Seal laryngeal mask either in a classic way, or with the help of laryngoscope. The fibreoptic evaluation Includes 4, only vocal cords visible; 3, vocal cords plus posterior epiglottis visible 2, vocal cords plus anterior epiglottis visible ; 1, vocal cords not seen. | First minute after laryngeal mask insertio | 
| complications of laryngeal mask insertion | complications like sore throat, hoarseness, nausea, and vomiting or Bloodstain on the laryngeal mask. we simply asked patients about them | Complications will be evaluated within 1 hour after patient recovery. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| hemodynamic response | Heart rate will record before LMA and post LMA used at first minute | Before putting on the Layngeal mask, it will record in beats / minute at 5 minutes for 1 minute and 20 minutes after wearing | 
| insertion time | Insertion time was defined from the time of removal of the facemask to the time of the appearance of first capnography upstroke. we assessed this outcome stopwatch | The investigator will record the insertion time in seconds from the moment the laryngeal mask airway passes the incisors until the end-tidal CO2 is visible. | 
| respiratory dynamics | The investigator will record the (tidal volume(ml) value from the mechanical ventilator after wearing the laryngeal mask. | The first minute after the laryngeal mask insertion, and every 5 minutes thereafter up to the 20th minute | 
| hemodynamic responce | mean blood pressure will record before LMA and post LMA used at first minute | Before putting on the Layngeal mask, it will record in mm Hg at 5 minutes for 1 minute and 20 minutes after wearing | 
| oxygen saturation | saturation will record before LMA and post LMA used at first minute | Before putting on the Layngeal mask, it will record in %SpO2 at 5 minutes for 1 minute and 20 minutes after wearing | 
| respiratory dynamics | The investigator will record the peak airway pressure (cmH2O) value from the mechanical ventilator after wearing the laryngeal mask. | The first minute after the laryngeal mask insertion, and every 5 minutes thereafter up to the 20th minute | 
| respiratory dynamics | The investigator will record the end-tidal CO2(mmHg) value from the mechanical ventilator after wearing the laryngeal mask. | The first minute after the laryngeal mask insertion, and every 5 minutes thereafter up to the 20th minute | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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laryngeal mask