The LMA® ProtectorTM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study
Summary We evaluated the LMA® ProtectorTM in 280 ASA physical status 1–3 patients aged 18–75 years by assessing the ease of insertion, insertion time, oropharyngeal leak pressure, ease of gastric tube passage and complications. First‐attempt and overall insertion success was 234/280 (84; 95%CI 79–88...
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| Veröffentlicht in: | Anaesthesia 2019-03, Vol.74 (3), p.333-339 |
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| creator | Zaballos, M. Zaballos, J. López, S. Fernández‐Dïez, A. I. Lluch‐Oltra, A. Mexedo, C. López, A. Reyes, A Varela, O Martínez‐Giner, J.V Burches, E Ramayo Díaz, N Bermejo, J.C Pérez‐Villafañe, A García‐Miguel, C Lameira dos Santos, D Riego del Castillo, N. Mateus, C Machado, H Domenech, J Montero, J Agusti‐Lasús, M Martínez‐Pons, V De la Cruz‐Alvarado, L Diéguez‐García, P Juncal‐Díaz, J |
| description | Summary
We evaluated the LMA® ProtectorTM in 280 ASA physical status 1–3 patients aged 18–75 years by assessing the ease of insertion, insertion time, oropharyngeal leak pressure, ease of gastric tube passage and complications. First‐attempt and overall insertion success was 234/280 (84; 95%CI 79–88%) and 274/280 (98; 95–99%). Median (IQR [range]) insertion time was 17 (12–25 [5–44]) s, and manoeuvres to facilitate insertion were required in 56 (50–63)% of patients. Median oropharyngeal leak pressure was 31 (26–36 [14–40]) cmH2O. Multivariate analysis identified two risk factors for oropharyngeal leak pressure |
| doi_str_mv | 10.1111/anae.14534 |
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We evaluated the LMA® ProtectorTM in 280 ASA physical status 1–3 patients aged 18–75 years by assessing the ease of insertion, insertion time, oropharyngeal leak pressure, ease of gastric tube passage and complications. First‐attempt and overall insertion success was 234/280 (84; 95%CI 79–88%) and 274/280 (98; 95–99%). Median (IQR [range]) insertion time was 17 (12–25 [5–44]) s, and manoeuvres to facilitate insertion were required in 56 (50–63)% of patients. Median oropharyngeal leak pressure was 31 (26–36 [14–40]) cmH2O. Multivariate analysis identified two risk factors for oropharyngeal leak pressure < 25 cmH2O: male sex (OR 2.44; 1.01–5.91, p = 0.048) and the insertion of a LMA size different to that recommended by weight (OR 1.98; 0.97–4.03, p = 0.06). Gastric tube insertion was possible in 256 out of 274 patients (93%). On fibreoptic view, vocal cords were visible in 86% of patients. During maintenance, 14 patients (5%) required airway manipulation. There were no episodes of regurgitation or aspiration. Blood staining on LMA removal was present in 70 out of 280 patients (25%). Use of the LMA Protector appears safe and is associated with a high success rate, provision of a highly effective seal and low rates of clinical complications. These attributes would suggest considerable potential for use during anaesthesia.</description><identifier>ISSN: 0003-2409</identifier><identifier>EISSN: 1365-2044</identifier><identifier>DOI: 10.1111/anae.14534</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>airway ; Anesthesia ; Complications ; Insertion ; LMA Protector ; multicentre study ; Multivariate analysis ; Observational studies ; Patients ; Pressure ; Protectors ; Regurgitation ; Respiratory tract ; Risk analysis ; Risk factors ; second‐generation supraglottic airway devices ; Vocal cords ; Weight</subject><ispartof>Anaesthesia, 2019-03, Vol.74 (3), p.333-339</ispartof><rights>2019 Association of Anaesthetists</rights><rights>Copyright © 2019 Association of Anaesthetists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fanae.14534$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fanae.14534$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids></links><search><creatorcontrib>Zaballos, M.</creatorcontrib><creatorcontrib>Zaballos, J.</creatorcontrib><creatorcontrib>López, S.</creatorcontrib><creatorcontrib>Fernández‐Dïez, A. I.</creatorcontrib><creatorcontrib>Lluch‐Oltra, A.</creatorcontrib><creatorcontrib>Mexedo, C.</creatorcontrib><creatorcontrib>López, A.</creatorcontrib><creatorcontrib>Reyes, A</creatorcontrib><creatorcontrib>Varela, O</creatorcontrib><creatorcontrib>Martínez‐Giner, J.V</creatorcontrib><creatorcontrib>Burches, E</creatorcontrib><creatorcontrib>Ramayo Díaz, N</creatorcontrib><creatorcontrib>Bermejo, J.C</creatorcontrib><creatorcontrib>Pérez‐Villafañe, A</creatorcontrib><creatorcontrib>García‐Miguel, C</creatorcontrib><creatorcontrib>Lameira dos Santos, D</creatorcontrib><creatorcontrib>Riego del Castillo, N.</creatorcontrib><creatorcontrib>Mateus, C</creatorcontrib><creatorcontrib>Machado, H</creatorcontrib><creatorcontrib>Domenech, J</creatorcontrib><creatorcontrib>Montero, J</creatorcontrib><creatorcontrib>Agusti‐Lasús, M</creatorcontrib><creatorcontrib>Martínez‐Pons, V</creatorcontrib><creatorcontrib>De la Cruz‐Alvarado, L</creatorcontrib><creatorcontrib>Diéguez‐García, P</creatorcontrib><creatorcontrib>Juncal‐Díaz, J</creatorcontrib><title>The LMA® ProtectorTM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study</title><title>Anaesthesia</title><description>Summary
We evaluated the LMA® ProtectorTM in 280 ASA physical status 1–3 patients aged 18–75 years by assessing the ease of insertion, insertion time, oropharyngeal leak pressure, ease of gastric tube passage and complications. First‐attempt and overall insertion success was 234/280 (84; 95%CI 79–88%) and 274/280 (98; 95–99%). Median (IQR [range]) insertion time was 17 (12–25 [5–44]) s, and manoeuvres to facilitate insertion were required in 56 (50–63)% of patients. Median oropharyngeal leak pressure was 31 (26–36 [14–40]) cmH2O. Multivariate analysis identified two risk factors for oropharyngeal leak pressure < 25 cmH2O: male sex (OR 2.44; 1.01–5.91, p = 0.048) and the insertion of a LMA size different to that recommended by weight (OR 1.98; 0.97–4.03, p = 0.06). Gastric tube insertion was possible in 256 out of 274 patients (93%). On fibreoptic view, vocal cords were visible in 86% of patients. During maintenance, 14 patients (5%) required airway manipulation. There were no episodes of regurgitation or aspiration. Blood staining on LMA removal was present in 70 out of 280 patients (25%). Use of the LMA Protector appears safe and is associated with a high success rate, provision of a highly effective seal and low rates of clinical complications. These attributes would suggest considerable potential for use during anaesthesia.</description><subject>airway</subject><subject>Anesthesia</subject><subject>Complications</subject><subject>Insertion</subject><subject>LMA Protector</subject><subject>multicentre study</subject><subject>Multivariate analysis</subject><subject>Observational studies</subject><subject>Patients</subject><subject>Pressure</subject><subject>Protectors</subject><subject>Regurgitation</subject><subject>Respiratory tract</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>second‐generation supraglottic airway devices</subject><subject>Vocal cords</subject><subject>Weight</subject><issn>0003-2409</issn><issn>1365-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNotkEtOwzAURS0EEqUwYQWWmJJix3acMIuq8pFaYJC55SS2miqNg-0UZcYSWAmLYCmsBLflTd5HR1f3XQCuMZrhUHeyk2qGKSP0BEwwSVgUI0pPwQQhRKKYouwcXDi3QQjHKU4nwBRrBZer_OcbvlnjVeWNLVaw6eBeyvm18o1T9S3sTPf7-dVLK9sxHGAvfaM67-6hhNuh9U0VNqtgb43rg0yzU9CUTtldAE0nW-j8UI-X4EzL1qmr_z4FxcOimD9Fy9fH53m-jHqOaKRopZCOSVUqymvJMlzWJeEZTmSSZhjFnJGkytJUM13ShMdZqSvJE60ZIpJpMgU3R9lg530If4iNGWxw4USMOccoSQkKFD5SH02rRtHbZivtKDAS-zDFPgFxCFPkL_niMJE_FeRtVA</recordid><startdate>201903</startdate><enddate>201903</enddate><creator>Zaballos, M.</creator><creator>Zaballos, J.</creator><creator>López, S.</creator><creator>Fernández‐Dïez, A. I.</creator><creator>Lluch‐Oltra, A.</creator><creator>Mexedo, C.</creator><creator>López, A.</creator><creator>Reyes, A</creator><creator>Varela, O</creator><creator>Martínez‐Giner, J.V</creator><creator>Burches, E</creator><creator>Ramayo Díaz, N</creator><creator>Bermejo, J.C</creator><creator>Pérez‐Villafañe, A</creator><creator>García‐Miguel, C</creator><creator>Lameira dos Santos, D</creator><creator>Riego del Castillo, N.</creator><creator>Mateus, C</creator><creator>Machado, H</creator><creator>Domenech, J</creator><creator>Montero, J</creator><creator>Agusti‐Lasús, M</creator><creator>Martínez‐Pons, V</creator><creator>De la Cruz‐Alvarado, L</creator><creator>Diéguez‐García, P</creator><creator>Juncal‐Díaz, J</creator><general>Blackwell Publishing Ltd</general><scope>7T5</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope></search><sort><creationdate>201903</creationdate><title>The LMA® ProtectorTM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study</title><author>Zaballos, M. ; Zaballos, J. ; López, S. ; Fernández‐Dïez, A. I. ; Lluch‐Oltra, A. ; Mexedo, C. ; López, A. ; Reyes, A ; Varela, O ; Martínez‐Giner, J.V ; Burches, E ; Ramayo Díaz, N ; Bermejo, J.C ; Pérez‐Villafañe, A ; García‐Miguel, C ; Lameira dos Santos, D ; Riego del Castillo, N. ; Mateus, C ; Machado, H ; Domenech, J ; Montero, J ; Agusti‐Lasús, M ; Martínez‐Pons, V ; De la Cruz‐Alvarado, L ; Diéguez‐García, P ; Juncal‐Díaz, J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p704-e4ce0f23cbe47da591bdb37916a6891027536c988f5fb46729bfca76ff503a5f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>airway</topic><topic>Anesthesia</topic><topic>Complications</topic><topic>Insertion</topic><topic>LMA Protector</topic><topic>multicentre study</topic><topic>Multivariate analysis</topic><topic>Observational studies</topic><topic>Patients</topic><topic>Pressure</topic><topic>Protectors</topic><topic>Regurgitation</topic><topic>Respiratory tract</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>second‐generation supraglottic airway devices</topic><topic>Vocal cords</topic><topic>Weight</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zaballos, M.</creatorcontrib><creatorcontrib>Zaballos, J.</creatorcontrib><creatorcontrib>López, S.</creatorcontrib><creatorcontrib>Fernández‐Dïez, A. I.</creatorcontrib><creatorcontrib>Lluch‐Oltra, A.</creatorcontrib><creatorcontrib>Mexedo, C.</creatorcontrib><creatorcontrib>López, A.</creatorcontrib><creatorcontrib>Reyes, A</creatorcontrib><creatorcontrib>Varela, O</creatorcontrib><creatorcontrib>Martínez‐Giner, J.V</creatorcontrib><creatorcontrib>Burches, E</creatorcontrib><creatorcontrib>Ramayo Díaz, N</creatorcontrib><creatorcontrib>Bermejo, J.C</creatorcontrib><creatorcontrib>Pérez‐Villafañe, A</creatorcontrib><creatorcontrib>García‐Miguel, C</creatorcontrib><creatorcontrib>Lameira dos Santos, D</creatorcontrib><creatorcontrib>Riego del Castillo, N.</creatorcontrib><creatorcontrib>Mateus, C</creatorcontrib><creatorcontrib>Machado, H</creatorcontrib><creatorcontrib>Domenech, J</creatorcontrib><creatorcontrib>Montero, J</creatorcontrib><creatorcontrib>Agusti‐Lasús, M</creatorcontrib><creatorcontrib>Martínez‐Pons, V</creatorcontrib><creatorcontrib>De la Cruz‐Alvarado, L</creatorcontrib><creatorcontrib>Diéguez‐García, P</creatorcontrib><creatorcontrib>Juncal‐Díaz, J</creatorcontrib><collection>Immunology Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Anaesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zaballos, M.</au><au>Zaballos, J.</au><au>López, S.</au><au>Fernández‐Dïez, A. I.</au><au>Lluch‐Oltra, A.</au><au>Mexedo, C.</au><au>López, A.</au><au>Reyes, A</au><au>Varela, O</au><au>Martínez‐Giner, J.V</au><au>Burches, E</au><au>Ramayo Díaz, N</au><au>Bermejo, J.C</au><au>Pérez‐Villafañe, A</au><au>García‐Miguel, C</au><au>Lameira dos Santos, D</au><au>Riego del Castillo, N.</au><au>Mateus, C</au><au>Machado, H</au><au>Domenech, J</au><au>Montero, J</au><au>Agusti‐Lasús, M</au><au>Martínez‐Pons, V</au><au>De la Cruz‐Alvarado, L</au><au>Diéguez‐García, P</au><au>Juncal‐Díaz, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The LMA® ProtectorTM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study</atitle><jtitle>Anaesthesia</jtitle><date>2019-03</date><risdate>2019</risdate><volume>74</volume><issue>3</issue><spage>333</spage><epage>339</epage><pages>333-339</pages><issn>0003-2409</issn><eissn>1365-2044</eissn><abstract>Summary
We evaluated the LMA® ProtectorTM in 280 ASA physical status 1–3 patients aged 18–75 years by assessing the ease of insertion, insertion time, oropharyngeal leak pressure, ease of gastric tube passage and complications. First‐attempt and overall insertion success was 234/280 (84; 95%CI 79–88%) and 274/280 (98; 95–99%). Median (IQR [range]) insertion time was 17 (12–25 [5–44]) s, and manoeuvres to facilitate insertion were required in 56 (50–63)% of patients. Median oropharyngeal leak pressure was 31 (26–36 [14–40]) cmH2O. Multivariate analysis identified two risk factors for oropharyngeal leak pressure < 25 cmH2O: male sex (OR 2.44; 1.01–5.91, p = 0.048) and the insertion of a LMA size different to that recommended by weight (OR 1.98; 0.97–4.03, p = 0.06). Gastric tube insertion was possible in 256 out of 274 patients (93%). On fibreoptic view, vocal cords were visible in 86% of patients. During maintenance, 14 patients (5%) required airway manipulation. There were no episodes of regurgitation or aspiration. Blood staining on LMA removal was present in 70 out of 280 patients (25%). Use of the LMA Protector appears safe and is associated with a high success rate, provision of a highly effective seal and low rates of clinical complications. These attributes would suggest considerable potential for use during anaesthesia.</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><doi>10.1111/anae.14534</doi><tpages>7</tpages></addata></record> |
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| subjects | airway Anesthesia Complications Insertion LMA Protector multicentre study Multivariate analysis Observational studies Patients Pressure Protectors Regurgitation Respiratory tract Risk analysis Risk factors second‐generation supraglottic airway devices Vocal cords Weight |
| title | The LMA® ProtectorTM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study |
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