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The randomized crossover comparison of airway sealing with the laryngeal mask airway SupremeTM at three different intracuff pressures in children

Authors
 Kwan-Woong Choi  ;  Jeong-Rim Lee  ;  Jung-Tak Oh  ;  Dong Wook Kim  ;  Min-Soo Kim 
Citation
 PEDIATRIC ANESTHESIA, Vol.24(10) : 1080-1087, 2014 
Journal Title
 PEDIATRIC ANESTHESIA 
ISSN
 1155-5645 
Issue Date
2014
MeSH
Air Pressure ; Airway Obstruction/epidemiology ; Airway Obstruction/etiology ; Anesthesia, Inhalation ; Anesthetics, Inhalation ; Child ; Child, Preschool ; Cross-Over Studies ; Female ; Humans ; Infant ; Infant, Newborn ; Laryngeal Masks* ; Male ; Methyl Ethers
Keywords
airway management ; anesthesia ; clinical trial ; laryngeal mask airway ; pediatrics ; sore throat
Abstract
BACKGROUND: An intracuff pressure of 80 cm H2 O in the adult-sized laryngeal mask airway Supreme has been recommended to obtain a higher oropharyngeal leak pressure (OLP). However, the intracuff pressure for the higher OLP in the pediatric laryngeal mask airway Supreme could be different from that in the adult-sized laryngeal mask airway Supreme. Thus, we measured and compared OLP at three intracuff pressures of 40, 60, and 80 cm H2 O in the pediatric laryngeal mask airway Supreme. METHODS: This study was designed as a randomized crossover study and enrolled 36 children, aged 0-108 months and 5-30 kg in weight. After insertion of the laryngeal mask airway Supreme, oropharyngeal leak pressure (OLP) was measured at intracuff pressures of 40, 60, and 80 cm H2 O according to one of six sequences produced on the basis of 3 × 6 Williams crossover design. During the intraoperative period, the laryngeal mask airway Supreme was maintained using the last intracuff pressure of the allocated sequence. The intraoperative and postoperative complications were compared among three maintenance intracuff pressures. RESULTS: OLP at the intracuff pressure of 60 cm H2 O was significantly higher than that of 40 cm H2 O (17.9 ± 3.9 vs 16.9 ± 4.2 cm H2 O, P = 0.004) and was comparable with that of 80 cm H2 O (17.9 ± 3.9 vs 17.8 ± 4.6 cm H2 O, P = 0.938). There were no significant differences of intraoperative and postoperative complications among the three maintenance intracuff pressures. CONCLUSION: Our results suggest that the use of an intracuff pressure of 60 cm H2 O in pediatric laryngeal mask airway Supreme provides a higher OLP compared with 40 cm H2 O.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/pan.12494/abstract
DOI
10.1111/pan.12494
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Dong Wook(김동욱)
Kim, Min Soo(김민수) ORCID logo https://orcid.org/0000-0001-8760-4568
Oh, Jung Tak(오정탁)
Lee, Jeong Rim(이정림) ORCID logo https://orcid.org/0000-0002-7425-0462
Choi, Kwan Woong(최관웅)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99539
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