Skip to main content Accessibility help
×
Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-29T06:00:50.269Z Has data issue: false hasContentIssue false

Chapter 5 - Supraglottic Airway Equipment and Techniques

from Section 2 - Devices and Techniques to Manage the Abnormal Airway

Published online by Cambridge University Press:  10 September 2019

Narasimhan Jagannathan
Affiliation:
Northwestern University Medical School, Illinois
John E. Fiadjoe
Affiliation:
Children’s Hospital of Philadelphia
Get access

Summary

SGA devices have been used successfully in patients of all ages in various clinical scenarios, including primary airway management under general anesthesia in the operating room, and resuscitation and emergent airway management in the emergency department (ED) and prehospital settings. SGA devices have been used as alternatives to face-mask ventilation and tracheal intubation by healthcare providers with proficient airway management skills, but also by those with less experience, to successfully oxygenate and ventilate the lungs. The clinical efficacy of SGA devices in children has been proven in a large number of clinical studies. Pediatric SGA devices have undergone an evolution in design since their introduction 30 years ago. These newer design features have improved the use of SGA devices to provide positive-pressure ventilation and facilitate fiberoptic-guided tracheal intubation. The evolution, versatility, and utility of the SGA device will be discussed in detail in this chapter.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brimacombe, J. A Proposed Classification System for Extraglottic Airway Devices. Anesthesiology 2004; 101(2): 559.Google Scholar
Miller, DM. A Proposed Classification and Scoring System for Supraglottic Sealing Airways: a Brief Review. Anesthesia & Analgesia 2004; 99(5): 1553–9; table of contents.Google Scholar
Nagai, K, Sakuramoto, C, Goto, F. Unilateral Hypoglossal Nerve Paralysis following the Use of the Laryngeal Mask Airway. Anaesthesia 1994; 49(7): 603–4.CrossRefGoogle ScholarPubMed
Marjot, R. Trauma to the Posterior Pharyngeal Wall Caused by a Laryngeal Mask Airway. Anaesthesia 1991; 46(7): 589–90.CrossRefGoogle Scholar
Burgard, G, Mollhoff, T, Prien, T. The Effect of Laryngeal Mask Cuff Pressure on Postoperative Sore Throat Incidence. Journal of Clinical Anesthesia 1996; 8(3): 198201.Google Scholar
Ong, M, Chambers, NA, Hullet, B, Erb, TO, von Ungern-Sternberg, BS. Laryngeal Mask Airway and Tracheal Tube Cuff Pressures in Children: are Clinical Endpoints Valuable for Guiding Inflation? Anaesthesia 2008; 63(7): 738–44.Google Scholar
Licina, A, Chambers, NA, Hullett, B, Erb, TO, von Ungern-Sternberg, BS. Lower Cuff Pressures Improve the Seal of Pediatric Laryngeal Mask Airways. Paediatric Anaesthesia 2008; 18(10): 952–6.Google Scholar
Hockings, L, Heaney, M, Chambers, NA, Erb, TO, von Ungern-Sternberg, BS. Reduced Air Leakage by Adjusting the Cuff Pressure in Pediatric Laryngeal Mask Airways during Spontaneous Ventilation. Paediatric Anaesthesia 2010; 20(4): 313–17.Google Scholar
Inagawa, G, Okuda, K, Miwa, T, Hiroki, K. Higher Airway Seal does Not Imply Adequate Positioning of Laryngeal Mask Airways in Paediatric Patients. Paediatric Anaesthesia 2002; 12(4): 322–6.Google Scholar
Goudsouzian, NG, Denman, W, Cleveland, R, Shorten, G. Radiologic Localization of the Laryngeal Mask Airway in Children. Anesthesiology 1992; 77(6): 1085–9.Google Scholar
Nakayama, S, Osaka, Y, Yamashita, M. The Rotational Technique with a Partially Inflated Laryngeal Mask Airway Improves the Ease of Insertion in Children. Paediatric Anaesthesia 2002; 12(5): 416–19.Google Scholar
McNicol, LR. Insertion of Laryngeal Mask Airway in Children. Anaesthesia 1991; 46(4): 330.CrossRefGoogle ScholarPubMed
Ghai, B, Ram, J, Makkar, JK, Wig, J. Fiber-Optic Assessment of LMA Position in Children: a Randomized Crossover Comparison of Two Techniques. Paediatric Anaesthesia 2011; 21(11): 1142–7.Google Scholar
Wong, DT, Yang, JJ, Mak, HY, Jagannathan, N. Use of Intubation Introducers through a Supraglottic Airway to Facilitate Tracheal Intubation: a Brief Review. Canadian Journal of Anaesthesia/Journal canadien d’anesthesie 2012; 59(7): 704–15.Google ScholarPubMed
Mathis, MR, Haydar, B, Taylor, EL, et al. Failure of the Laryngeal Mask Airway Unique and Classic in the Pediatric Surgical Patient: a Study of Clinical Predictors and Outcomes. Anesthesiology 2013; 119(6): 1284–95.Google Scholar
Walker, RW, Allen, DL, Rothera, MR. A Fibreoptic Intubation Technique for Children with Mucopolysaccharidoses Using the Laryngeal Mask Airway. Paediatric Anaesthesia 1997; 7(5): 421–6.Google Scholar
Inada, T, Fujise, K, Tachibana, K, Shingu, K. Orotracheal Intubation through the Laryngeal Mask Airway in Paediatric Patients with Treacher-Collins Syndrome. Paediatric Anaesthesia 1995; 5(2): 129–32.CrossRefGoogle ScholarPubMed
Asai, T, Nagata, A, Shingu, K. Awake Tracheal Intubation through the Laryngeal Mask in Neonates with Upper Airway Obstruction. Paediatric Anaesthesia 2008; 18(1): 7780.Google Scholar
Lopez-Gil, M, Brimacombe, J, Alvarez, M. Safety and Efficacy of the Laryngeal Mask Airway. A Prospective Survey of 1400 Children. Anaesthesia 1996; 51(10): 969–72.Google Scholar
Shimbori, H, Ono, K, Miwa, T, Morimura, N, Noguchi, M, Hiroki, K. Comparison of the LMA-ProSeal and LMA-Classic in Children. British Journal of Anaesthesia 2004; 93(4): 528–31.CrossRefGoogle ScholarPubMed
Goldmann, K, Jakob, C. A Randomized Crossover Comparison of the Size 2 1/2 Laryngeal Mask Airway ProSeal versus Laryngeal Mask Airway-Classic in Pediatric Patients. Anesthesia and Analgesia 2005; 100(6): 1605–10.Google Scholar
Micaglio, M, Ori, C, Parotto, M, Zanardo, V, Trevisanuto, D. The ProSeal Laryngeal Mask Airway for Neonatal Resuscitation: First Reports. Paediatric Anaesthesia 2007; 17(5): 499; author reply, 499–500.CrossRefGoogle ScholarPubMed
Jagannathan, N, Sohn, L, Sommers, K, et al. A Randomized Comparison of the Laryngeal Mask Airway Supreme and Laryngeal Mask Airway Unique in Infants and Children: Does Cuff Pressure Influence Leak Pressure? Paediatric Anaesthesia 2013; 23(10): 927–33.Google Scholar
Jagannathan, N, Sohn, LE, Sawardekar, A, Chang, E, Langen, KE, Anderson, K. A Randomised Trial Comparing the Laryngeal Mask Airway Supreme with the Laryngeal Mask Airway Unique in Children. Anaesthesia 2012; 67(2): 139–44.Google Scholar
Jagannathan, N, Sommers, K, Sohn, LE, et al. A Randomized Equivalence Trial Comparing the i-gel and Laryngeal Mask Airway Supreme in Children. Paediatric Anaesthesia 2013; 23(2): 127–33.Google Scholar
Trevisanuto, D, Cavallin, F, Nguyen, LN, et al. Supreme Laryngeal Mask Airway versus Face Mask during Neonatal Resuscitation: a Randomized Controlled Trial. The Journal of Pediatrics 2015; 167(2): 286–91 e281.Google Scholar
Jagannathan, N, Sohn, LE, Eidem, JM. Use of the air-Q Intubating Laryngeal Airway for Rapid-Sequence Intubation in Infants with Severe Airway Obstruction: a Case Series. Anaesthesia 2013; 68(6): 636–8.Google Scholar
Jagannathan, N, Roth, AG, Sohn, LE, Pak, TY, Amin, S, Suresh, S. The New air-Q Intubating Laryngeal Airway for Tracheal Intubation in Children with Anticipated Difficult Airway: a Case Series. Paediatric Anaesthesia 2009; 19(6): 618–22.Google Scholar
Fiadjoe, JE, Stricker, PA. The air-Q Intubating Laryngeal Airway in Neonates with Difficult Airways. Paediatric Anaesthesia 2011; 21(6): 702–3.Google Scholar
Kleine-Brueggeney, M, Nicolet, A, Nabecker, S, et al. Blind Intubation of Anaesthetised Children with Supraglottic Airway Devices Ambu Aura-i and Air-Q Cannot be Recommended: a Randomised Controlled Trial. European Journal of Anaesthesiology 2015; 32(9): 631–9.Google Scholar
Jagannathan, N, Sohn, LE, Mankoo, R, Langen, KE, Mandler, T. A Randomized Crossover Comparison between the Laryngeal Mask Airway-Unique and the air-Q Intubating Laryngeal Airway in Children. Paediatric Anaesthesia 2012; 22(2): 161–7.Google Scholar
Jagannathan, N, Sohn, LE, Sawardekar, A, et al. A Randomised Comparison of the Self-Pressurised air-Q Intubating Laryngeal Airway with the LMA Unique in Children. Anaesthesia 2012; 67(9): 973–9.Google ScholarPubMed
Fukuhara, A, Okutani, R, Oda, Y. A Randomized Comparison of the i-gel and the ProSeal Laryngeal Mask Airway in Pediatric Patients: Performance and Fiberoptic Findings. Journal of Anesthesia 2013; 27(1): 16.Google Scholar
Goyal, R, Shukla, RN, Kumar, G. Comparison of Size 2 i-gel Supraglottic Airway with LMA-ProSeal and LMA-Classic in Spontaneously Breathing Children Undergoing Elective Surgery. Paediatric Anaesthesia 2012; 22(4): 355–9.Google Scholar
Lee, JR, Kim, MS, Kim, JT, et al. A Randomised Trial Comparing the i-gel with the LMA Classic in Children. Anaesthesia 2012; 67(6): 606–11.CrossRefGoogle ScholarPubMed
Dhanger, S, Adinarayanan, S, Vinayagam, S, Kumar, MP. I-gel Assisted Fiberoptic Intubation in a Child with Morquio’s Syndrome. Saudi Journal of Anaesthesia 2015; 9(2): 217–19.Google Scholar
Jagannathan, N, Sohn, L, Ramsey, M, et al. A Randomized Comparison between the i-gel and the air-Q Supraglottic Airways when Used by Anesthesiology Trainees as Conduits for Tracheal Intubation in Children. Canadian Journal of Anaesthesia/Journal canadien d’Anesthesie 2015; 62(6): 587–94.Google Scholar
Kim, YL, Seo, DM, Shim, KS, et al. Successful Tracheal Intubation Using Fiberoptic Bronchoscope via an i-gel Supraglottic Airway in a Pediatric Patient with Goldenhar Syndrome – a Case Report. Korean Journal of Anesthesiology 2013; 65(1): 61–5.Google Scholar
Hughes, C, Place, K, Berg, S, Mason, D. A Clinical Evaluation of the i-gel Supraglottic Airway Device in Children. Paediatric Anaesthesia 2012; 22(8): 765–71.Google Scholar
Theiler, LG, Kleine-Brueggeney, M, Luepold, B, et al. Performance of the Pediatric-Sized i-gel Compared with the Ambu AuraOnce Laryngeal Mask in Anesthetized and Ventilated Children. Anesthesiology 2011; 115(1): 102–10.Google Scholar
Jagannathan, N, Sohn, LE, Sawardekar, A, et al. A Randomized Trial Comparing the Ambu Aura-i with the air-Q Intubating Laryngeal Airway as Conduits for Tracheal Intubation in Children. Paediatric Anaesthesia 2012; 22(12): 1197–204.CrossRefGoogle ScholarPubMed
Darlong, V, Biyani, G, Baidya, DK, et al. Comparison of air-Q and Ambu Aura-i for Controlled Ventilation in Infants: a Randomized Controlled Trial. Paediatric Anaesthesia 2015; 25(8): 795800.Google Scholar
Jagannathan, N, Hajduk, J, Sohn, L, et al. A Randomised Comparison of the Ambu AuraGain and the LMA Supreme in Infants and Children. Anaesthesia 2016; 71(2): 205–12.Google Scholar
Richebe, P, Semjen, F, Cros, AM, Maurette, P. Clinical Assessment of the Laryngeal Tube in Pediatric Anesthesia. Paediatric Anaesthesia 2005; 15(5): 391–6.Google Scholar
Scheller, B, Schalk, R, Byhahn, C, et al. Laryngeal Tube Suction II for Difficult Airway Management in Neonates and Small Infants. Resuscitation 2009; 80(7): 805–10.CrossRefGoogle ScholarPubMed
Gaitini, L, Yanovski, B, Toame, R, Carmi, N, Somri, M. Laryngeal Tube Suction II versus the ProSeal Laryngeal Mask in Anesthetized Children with Spontaneous Ventilation: 19AP6–3. European Journal of Anaesthesiology 2007; 24: 203.Google Scholar
Szmuk, P, Ghelber, O, Matuszczak, M, Rabb, MF, Ezri, T, Sessler, DI. A Prospective, Randomized Comparison of Cobra Perilaryngeal Airway and Laryngeal Mask Airway Unique in Pediatric Patients. Anesthesia & Analgesia 2008; 107(5): 1523–30.Google Scholar
Gaitini, L, Carmi, N, Yanovski, B, et al. Comparison of the CobraPLA (Cobra Perilaryngeal Airway) and the Laryngeal Mask Airway Unique in Children under Pressure Controlled Ventilation. Paediatric Anaesthesia 2008; 18(4): 313–19.Google Scholar
Passariello, M, Almenrader, N, Coccetti, B, Haiberger, R, Pietropaoli, P. Insertion Characteristics, Sealing Pressure and Fiberoptic Positioning of CobraPLA in Children. Paediatric Anaesthesia 2007; 17(10): 977–82.Google Scholar
Polaner, DM, Ahuja, D, Zuk, J, Pan, Z. Video Assessment of Supraglottic Airway Orientation through the Perilaryngeal Airway in Pediatric Patients. Anesthesia & Analgesia 2006; 102(6): 1685–8.Google Scholar
Sunder, RA, Sinha, R, Agarwal, A, Perumal, BC, Paneerselvam, SR. Comparison of Cobra Perilaryngeal Airway (CobraPLA) with Flexible Laryngeal Mask Airway in Terms of Device Stability and Ventilation Characteristics in Pediatric Ophthalmic Surgery. Journal of Anaesthesiology, Clinical Pharmacology 2012; 28(3): 322–5.Google Scholar
Timmermann, A. Supraglottic Airways in Difficult Airway Management: Successes, Failures, Use and Misuse. Anaesthesia 2011; 66(Suppl.2): 4556.Google Scholar
Mironov, PI, Estekhin, AM, Mirasov, AA. Anaesthetic Maintenance with Laryngeal Mask for a Laparoscopic Surgery in Pediatric Patients. Anesteziologija i Reanimatologiia 2013; 1: 1014.Google Scholar
Sinha, A, Sharma, B, Sood, J. ProSeal as an Alternative to Endotracheal Intubation in Pediatric Laparoscopy. Paediatric Anaesthesia 2007; 17(4): 327–32.Google Scholar
Clarke, MB, Forster, P, Cook, TM. Airway Management for Tonsillectomy: a National Survey of UK Practice. British Journal of Anaesthesia 2007; 99(3): 425–8.Google Scholar
John, RE, Hill, S, Hughes, TJ. Airway Protection by the Laryngeal Mask. A Barrier to Dye Placed in the Pharynx. Anaesthesia 1991; 46(5): 366–7.Google Scholar
Peng, A, Dodson, KM, Thacker, LR, Kierce, J, Shapiro, J, Baldassari, CM. Use of Laryngeal Mask Airway in Pediatric Adenotonsillectomy. Archives of Otolaryngology – Head & Neck Surgery 2011; 137(1): 42–6.Google Scholar
Sierpina, DI, Chaudhary, H, Walner, DL, et al. Laryngeal Mask Airway versus Endotracheal Tube in Pediatric Adenotonsillectomy. The Laryngoscope 2012; 122(2): 429–35.CrossRefGoogle ScholarPubMed
Alexander, R, Chinery, JP, Swales, H, Sutton, D. “Mouth to Mouth Ventilation”: a Comparison of the Laryngeal Mask Airway with the Laerdal Pocket Facemask. Resuscitation 2009; 80(11): 1240–3.CrossRefGoogle ScholarPubMed
Timmermann, A, Russo, SG, Crozier, TA, et al. Novices Ventilate and Intubate Quicker and Safer via Intubating Laryngeal Mask than by Conventional Bag-Mask Ventilation and Laryngoscopy. Anesthesiology 2007; 107(4): 570–6.Google Scholar
Schmolzer, GM, Agarwal, M, Kamlin, CO, Davis, PG. Supraglottic Airway Devices during Neonatal Resuscitation: an Historical Perspective, Systematic Review and Meta-Analysis of Available Clinical Trials. Resuscitation 2013; 84(6): 722–30.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×