Airway Management, General Anesthesia
Conditions
Keywords
LMA, Protector, Airway Device Evaluation, iGel, Airway Device Comparison
Brief summary
This will be a randomized comparative study comparing the two supraglottic devices i-gel and Protector, intraoperatively, during minor urological procedures under general anesthesia in adult patient.
Detailed description
This randomized comparative study aims to evaluate the effectiveness, safety, and unwanted effects of two laryngeal mask airway devices, the iGel and the Protector. The study will involve adult patients during minor urological procedures under general anesthesia. Participants will be divided into two groups: in one group will be inserted the iGel laryngeal mask airway, while in the other group will be inserted the Protector laryngeal mask airway.
Interventions
DEVICELMA igel
adults allocated to the LMA igel group, an LMA igel device will be inserted intraoperatively
DEVICELMA protector
adults allocated to the LMA protector group, an LMA protector device will be inserted intraoperatively
Sponsors
Nikolopoulou Maria Zozefin
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
Yes
Inclusion criteria
* ASA I-II * Patients older than 18 years * Procedures in supine and lithotomy position
Exclusion criteria
* Tumors or anatomical anomalies of the upper airway * Known history of difficult intubation * Limited mouth opening less than 2cm * Decreased compliance of the lungs or the thoracic cage * Need of mechanical ventilation after the surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of the airway sealing pressure of the Laryngeal Mask Airway (LMA) in neutral, extended, and extended-rotated head positions | Leak pressure will be measured in cmH2O within 60 seconds after successful placement: first in the neutral position, second in the extended position, and third in the extended rotated head position | After the closure of the adjustable pressure limiting valve (APL) of the ventilation machine with a continuous fresh gas flow of 3L/min, a stethoscope for auscultation will be placed to the lateral position of the thyroid cartilage. Leak pressure is defined as the maximum airway pressure (Ppeak) during which no audible sound, like leak, is detected with the placement of the stethoscope at the thyroid cartilage. Successful placement of the laryngeal mask, will be confirmed right after insertion by the auscultation of both hemithoraces, the indication of capnography, and the ratio of inhaled to exhaled pulmonary volume |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Success rate of each device for patients with a potential difficult airway according to the Simplified Airway Index | The patients airway will be evaluated 24 hours before surgery based on the Simplified Airway Index for a potential difficult intubation | The Simplified Airway Risk Index is a multivariate risk score, ranging from 0 to 12 points, thought to estimate the risk of difficult tracheal intubation based on seven parameters. These seven parameters include the mouth opening, where a mouth opening greater than 4 centimeters between the incisors results in 0 points whereas a distance below results in 1 point, the thyromental distance where thyromental distance greater than 6.5 centimeters results in 0 point whereas a distance between 6-6.5 centimeters is given 1 point and finally a distance below 6 centimeters is given 2 points, the mallampati score where Class I and II of the modified mallampati scoring results in 0 points whereas a class III is given 1 point and a class IV 2 points, the movement of the neck where the ability to move the neck more than 90 degrees results in 0 points whereas a movement range of 80-90 degrees results in 1 point and a movement range below 80 degrees results in 2 points, the ability to underbite mean |
| The time required for successful placement of the device | Measured from the moment the clinician picks up the LMA device after induction of general anesthesia until the appearance of the first capnography waveform on the monitor with a maximum duration of 60 seconds per attempt and up to three attempts allowed | This process will involve a maximum of three attempts |
| Number of attempts to successfully place a nasogastric tube through the specially designed channels of the laryngeal mask | Each attempt, from the moment the clinician picks up the nasogastric tube, will have a time frame of 5 seconds. If the nasogastric tube is not placed within 5 seconds, the attempt will be considered a failure | The ease of placement will be assessed by counting the number of attempts required to successfully place the nasogastric tube. Success is defined as the ability to place the tube without complications. Easy is defined as successful placement on the first attempt, moderate as placement on the second attempt, and difficult as placement on the third attempt. If placement is not achieved within three attempts, the procedure will be considered unsuccessful. Successful placement will by assessed by the successful suction of gastric fluid |
| Documentation of adverse events after the exertion | Immediately after the exertion | Complications like blood-stain visible on the LMA after exertion and post-operative sore throat |
Countries
Greece
Contacts
Primary ContactMaria Zozefin Nikolopoulou
Outcome results
None listed