Blind vs. video-laryngoscope-guided laryngeal mask insertion: A prospective randomized comparison of oropharyngeal leak pressure and fiberoptic grading,Journal of Clinical Monitoring and Computing

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Blind vs. video-laryngoscope-guided laryngeal mask insertion: A prospective randomized comparison of oropharyngeal leak pressure and fiberoptic grading
Journal of Clinical Monitoring and Computing ( IF 2.0 ) Pub Date : 2022-05-26 , DOI: 10.1007/s10877-022-00841-1
Tahsin Simsek ₁ , Ayten Saracoglu ₂ , Ozlem Sezen ₁ , Gul Cakmak ₂ , Kemal Tolga Saracoglu ₁

Affiliation

Purpose

Laryngeal Mask Airway (LMA) insertion may not always be smooth without complications. Controversial results of several studies evaluating ideal insertion conditions have been published. This study compared the oropharyngeal leak pressure values and fiberoptic grading scores between blind and video-laryngoscope-guided LMA insertion.

Methods

Patients were randomly assigned into blind insertion (n = 50) and video-laryngoscope guided insertion (n = 50) groups. The oropharyngeal leak pressure, peak airway pressure, fiberoptic grading score, first attempt success rate, hemodynamic parameters, and complications were recorded.

Results

All laryngeal mask airways were successfully inserted in both groups at the first attempt. The fiberoptic staging scores were: grade 1 in 8.2% of patients, grade 2 in 24.4% of patients, grade 3 in 44.8% of patients, grade 4 in 22.4% of patients in the control group. On the other hand, grade 1 in 2.2% of patients, grade 2 in 28.6% of patients, grade 3 in 51% of patients, grade 4 in 8.2% of patients in the VL group (p = 0.260). The peak airway pressure and LMA insertion time were similar between groups. However, the oropharyngeal leak pressure before extubation was significantly higher in the video-laryngoscope-guided insertion than blind insertion (36.29 ± 7.09 vs. 33.79 ± 8.84 cmH2O respectively, p = 0.04).

Conclusions

The findings of our study suggest that the video-laryngoscope-guided LMA-Classic insertion with a standard blade technique may be a helpful alternative to blind insertion.

中文翻译：

盲人与视频喉镜引导的喉罩插入：口咽漏压力和光纤分级的前瞻性随机比较

目的

喉罩气道 (LMA) 插入可能并不总是顺利而没有并发症。评估理想插入条件的几项研究的有争议的结果已经发表。本研究比较了盲法和视频喉镜引导下的 LMA 插入之间的口咽泄漏压力值和光纤分级评分。

方法

患者被随机分配到盲插入组（n = 50）和视频喉镜引导插入组（n = 50）。记录口咽漏压、气道峰值压力、光纤分级评分、首次尝试成功率、血流动力学参数和并发症。

结果

在第一次尝试时，两组的所有喉罩气道均成功插入。纤维分期评分为：8.2% 的患者为 1 级，24.4% 的患者为 2 级，44.8% 的患者为 3 级，对照组 22.4% 的患者为 4 级。另一方面，VL 组 2.2% 的患者为 1 级，28.6% 的患者为 2 级，51% 的患者为 3 级，8.2% 的患者为 4 级（p = 0.260）。各组之间的气道峰值压力和LMA插入时间相似。然而，在视频喉镜引导下插入拔管前的口咽泄漏压力明显高于盲插（分别为 36.29 ± 7.09 和 33.79 ± 8.84 cmH2O，p = 0.04）。