Comparison of three methods for the confirmation of laryngeal mask airway placement in female patients undergoing gynecologic surgery.
The laryngeal mask airway (LMA) is a supraglottic device that is commonly used to provide lung ventilation during general anesthesia. LMA placement needs to be confirmed to provide adequate lung ventilation. To investigate the feasibility of using ultrasound examination, compared with clinical tests and fiberoptic laryngoscopy, to confirm LMA placement, we performed a clinical study of 64 female patients classified as American Society of Anesthesiologists Physical Status I or II who were scheduled for gynecologic surgery with LMA insertion for airway management. After insertion, placement of the LMA was confirmed by clinical tests, ultrasound examination and fiberoptic laryngoscopy. Of the 64 women, placement was confirmed as acceptable in 89.1% by clinical tests, in 59.4% by fiberoptic laryngoscope assessment and in 67.2% by ultrasound examination. With respect to patients with oropharyngeal leaks classified as high, there were no differences in confirmation of acceptable placement between clinical tests and ultrasound examinations (p = 0.092), but the number of patients determined to have acceptable placement by ultrasound examination was greater than that determined by fiberoptic laryngoscopy (p = 0.034). Thus, ultrasound examination is a superior technique for confirming the seal on the LMA.
Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Zhen-feng
ZF
Zhou
Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Chen-zhong
CZ
Xia
Department of Anesthesiology, YinZhou Hospital Affiliated to Medical School of NingBo University, NingBo, China.
Meng
M
Wu
Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Li-na
LN
Yu
Department of Anesthesiology, YinZhou Hospital Affiliated to Medical School of NingBo University, NingBo, China.
Guo-zhang
GZ
Yan
Department of Anesthesiology, YinZhou Hospital Affiliated to Medical School of NingBo University, NingBo, China.
Qiu-sheng
QS
Ren
Department of Anesthesiology, YinZhou Hospital Affiliated to Medical School of NingBo University, NingBo, China.
Ci-xian
CX
Hu
Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. Electronic address: Yanminnina@hotmail.com.
Min
M
Yan
D000773:Anesthesia, Obstetrical / Q000295:instrumentation / Q000379:methods*; D004947:Esophagus / Q000000981:diagnostic imaging*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D017214:Laryngeal Masks; D007828:Laryngoscopy; D007830:Larynx / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
Clinical tests; Fiberoptic laryngoscope; Laryngeal mask airway; Placement; Ultrasound