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ISSN 3061-8142 (Electronic)
ISSN 0484-7903 (Print)

2003, Number 4

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Rev Mex Anest 2003; 26 (4)

Llenado pasivo del manguito de la mascarilla laríngea, como una alternativa del inflado convencional

Cruz-Villaseńor JA, Guadarrama QF, Rodríguez PMV, Porras QR, Pérez FR, Alvarado SE, Cendón OM, Chávez RMA

Language: Spanish
References: 20
Page: 203-208
PDF size: 192.49 Kb.


ABSTRACT

Introduction: Using laryngeal mask airway (LMA) for anesthetic procedures has been related to sore throat, nerve lesion, epiglottitis, dysphonia and luxation of the arytenoids, which are probably due to pressure exerted by LMA. Objective: To compare alternative methods for LMA’s cuff inflation as to lessen pressure on laryngeal mucose while optimizing LMA characteristics. Material and methods: A controlled, blind, prospective, longitudinal, comparative and observational clinical trial was conducted in forty individuals randomly assigned to two groups: 1) Passive inflation-connection of LMA pilot to a three-way stopcock and cuff open to atmospheric pressure (PITG), 2) Standard inflation technique (SITG). LMA position, airway sealing and sore throat were evaluated. LMA’s cuff pressure and that exerted on pharyngeal mucose were measured and calculated, respectively. Statistical analysis was carried out by applying central tendency and dispersion measurements, percentage measurements, Student’s t test and Fisher´s Exact test with statistical significance established at p < 0.05. Results: Initial cuff pressure was 9 + 6 cm H2O in PITG and 89 + 10 cm H2O in SITG (p < 0.01). Pressure exerted on pharyngeal mucose was 4 + 3 cm H2O in PITG and 24 + 4 cm H2O in SITG (p < 0.04). There was no statistical difference in sore throat. Conclusions: Passive inflation technique produces adequate airway sealing which it is as safe as the one obtained by standard inflation technique but pressure generated by LMA’s cuff on pharyngeal mucose is significatively lower than that produced by standard technique.


REFERENCES

  1. Brain AIJ. The laryngeal mask - a new concept in airway management. Br J Anaesth 1983;55:801-05.

  2. Wakeling H, Butler P, Baxter P. The Laryngeal Mask Airway: A comparison Between Two Insertion Techniques. Anesth Analg 1997;85:687-90.

  3. Yodfat U. Modified Technique for Laryngeal Mask Airway Insertion [letter]. Anest Analg 1999;89:1326-34.

  4. Asai T, Howell T, Koga K, Morris S. Appropriate size and inflation of the laryngeal mask airway. Br J Anaesth 1998;80:470-74.

  5. Slater P, Lavies NG. Optimum LMA cuff pressure [letter]. Anaesthesia 1996;51:1187.

  6. Grady DM, McHardy F, Wong J, Jin F, Tong D, Chung F. Pharingolaryngeal Morbidity with the Laryngeal Mask Airway in Spontaneously Breathing Patients. Does size matter? Anesthesiology 2001:94:760-6.

  7. McHardy FE, Chung F. Postoperative sore throat: cause, prevention and treatment. Anaesthesia 1999;54:444-53.

  8. Rieger A, Brunne B, Striebel HW. Intracuff pressures do not predict laryngopharyngeal discomfort after use of the laryngeal mask airway. Anesthesiology 1997:87:63-7.

  9. Gaylard D. Lingual nerve injury following the use of the laryngeal mask airway [letter]. Anaesth Intensive Care 1999:27:668.

  10. Keller C, Puehringer F, Brimacombe J. The influence of cuff volume on oropharyngeal leak pressure and fiberoptic position with the laryngeal mask airway. Br J Anaesth 1998:81:186-7.

  11. Keller C, Brimacombe J. Mucosal Pressure, Mechanism of seal, airway sealing Pressure, and anatomic position for the Disposable versus Reusable laryngeal mask airways. Anesth Analg 1999;88:1418-20.

  12. Brimacombe J, Berry A, Brain AIJ. Optimal intracuff pressures with the laryngeal mask [letter; comment]. Br J Anaesth 1996;77:295-6.

  13. Brimacombe J, Berry A. A proposed Fiber-Optic Scoring System to Standardize the Assessment of Laryngeal Mask Airway Position [letter]. Anesth Analg 1993;76:457.

  14. Asai T, Takashi, Morris S, Stephen. The laryngeal mask airway: its features, effects and role. Review article. Can J Anaesth 1994;41:930-60.

  15. Alexander CA, Leach AB. Incidence of sore throat with the laryngeal mask (letter). Anaesthesia 1989;44:791.

  16. Dingley J, Whitehead MJ, et al. A comparative study of sore throat with the laryngeal mask airway. Anaesthesia 1994;49:251-54.

  17. Burgard G, Mollhof T, Prien T. The effect of laryngeal mask cuff pressure on postoperative sore throat incidence. J Clin Anesth 1996;8:198-201.

  18. Marjot R. Pressure exerted by the laryngeal mask airway cuff upon the pharyngeal mucosa. Br J Anaesth 1993;70:25-9.

  19. Nagai K, Sakuramoto C, Goto F. Unilateral hypoglossal nerve paralysis following the use of the laryngeal mask airway. Anaesthesia 1994:49:603-4.

  20. King C, Street MK. Twelfth cranial nerve paralysis following use of a laryngeal mask airway. Anaesthesia 1994:49:786-7.




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