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

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Abstract

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.

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care, Health University Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey

    Tahsin Simsek MD, Ozlem Sezen MD & Kemal Tolga Saracoglu

  2. Department of Anesthesiology and Intensive Care, Marmara University Medical School, Istanbul, Turkey

    Ayten Saracoglu & Gul Cakmak MD

Authors
  1. Tahsin Simsek MD
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  2. Ayten Saracoglu
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  3. Ozlem Sezen MD
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  4. Gul Cakmak MD
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  5. Kemal Tolga Saracoglu
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Contributions

Ayten Saracoglu: data curation, conceptualization, methodology, writing reviewing & editing. Tahsin Simsek: data curation, writing- original draft preparation, software, validation, investigation. Ozlem Sezen: writing- original draft preparation, conceptualization, methodology. Gul Cakmak: corresponding author, visualization, writing - reviewing & editing. Kemal Tolga Saracoglu: supervision, visualization.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

The authors have no conflicts of interest to declare relevant to this article’s content.

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Marmara University Faculty of Medicine (Date 02.02.2018/ No 09.2018.134).

Corresponding author

Correspondence to Gul Cakmak MD.

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Simsek, T., Saracoglu, A., Sezen, O. et al. Blind vs. video-laryngoscope-guided laryngeal mask insertion: A prospective randomized comparison of oropharyngeal leak pressure and fiberoptic grading. J Clin Monit Comput 36, 1249–1255 (2022). https://doi.org/10.1007/s10877-022-00841-1

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  • DOI: https://doi.org/10.1007/s10877-022-00841-1

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