Person: ESEN, ASIM
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Publication Metadata only A new technique at insertion of laryngeal mask airway(2013-06-04) Esen A.; Bakan M.; Topuz U.; Ertaş Dursun Z.; Karaaslan K.; ESEN, ASIM; KARAASLAN, KAZıMA new technique at insertion of laryngeal mask airway Esen A., Bakan M., Topuz U., Ertas Z., Karaaslan K. (Bezmialem Vakif University, Dept of Anaesthesiology & Intensive Care, Istanbul, Turkey) Background and Goal of Study: Laryngeal mask airway (LMA) have been frequently used for airway management. The satisfaction of the insertion and trauma at insertion are problems. We present a new in insertion technique for LMA with partially inflated cuff. Materials and Methods: Consecutive 157 patients undergoing general anesthesia with LMA were randomized to two groups by coin toss. Induction and maintenance of anesthesia were standart in two groups. There were 85 patients in study group (group S) and 72 patients in control group (group C). LMA insertions were made by same physician. LMA was inserted with standart technique -which was described by Brain- at group C. Laryngeal mask airway was inserted with new techinque at group S. In new technique the head was positioned with extension by nondominant hand, mouth was opened with dominant hand, LMA was held with dominant hand from the tube part and inserted until the tip touches to the oropharynx. The index finger of nondominant hand was inserted to mouth to pass by the LMA and reach the tip of it and the tip of LMA was directed to caudal by index finger. Then LMA was inserted by the guidance of the index finger towards it reaches to the trianguler base of the orophariynx. Results and Discussion: There were no difference between the groups for the demographic details, ASA scores, insertion success and duration of anesthesia. The mean age was 47 ,4 for group S and 51,7 for group C. Count of attempt was better in study group. Mean count number was 1,11 at group S and 1,28 at group C (p=0.02). Also blood on LMA were seen more common at group C (p=0.04). There were no statistical difference at sore throat but it was less seen at group S. Also airway satisfaction was not statistical different between groups but while all airways were succesfull in group S we can not inserted LMA by standart method at 1 patient and inserted it at first attempt by new technique. Conclusion: New technique is less traumatic and easy to use at daily practice. References: 1. Brain AIJ : The laryngeal mask. A new consept in airway management. Br J Anaesth 55:801,1983. 2. Asai T, Morris S : The laryngeal mask airway: its’ features, effects and role. Can J Anaesth 41:930-60, 1994. 3. Wakeling HG, Butler PJ, Baxter PJ : The laryngeal mask airway: a comparison between two insertion techniques. Anesth Analg 85:687-90,1997.Publication Metadata only A new maneuver for classical laryngeal mask airway insertion: Prospective randomized study(2022-08-01) Esen A.; Bakan M.; Topuz U.; Ertaş Dursun Z.; Karaaslan K.; ESEN, ASIM; KARAASLAN, KAZıMBackground/Aim: Laryngeal mask airway (LMA) has been frequently used for airway management. But the satisfaction of the insertion and trauma at insertion remain problems. We present a new insertion maneuver for classical LMA (cLMA) with a partially inflated cuff and examine its success and complication rate.Methods: In 4 months, 158 patients who were classified as ASA I–III and older than 18 years old and were planned for LMA were included in this study consecutively (according to the study design, one patient was excluded during the study). Emergency cases, patients with any contraindications with LMA, patients who were expected to undergo surgery for more than 2 h, patients with preoperative respiratory tract infection or sore throat, patients undergoing oral or nasal surgery, and patients with aspirated oropharyngeal secretions after removal of LMA was excluded from the study. Age, gender, height, weight, ASA scores, comorbidities, and the duration of anesthesia and surgery of the patients were recorded. One-hundred-fifty-seven consecutive patients were randomized into two groups by a coin toss [control group (group C) and study group (group S)]. The groups were compared in terms of LMA insertion success, the number of insertion attempts, the presence of blood on the LMA or in secretions, and postoperative sore throat. Classical Laryngeal Mask Airway was inserted with Brain’s standard technique in group C and with the new technique in group S. In the new technique, the head and neck of the patient were supported in a straight position, the mouth was opened, cLMA was held with a dominant hand from the tube part and inserted until the tip touches to the oropharynx. The index finger of the non-dominant hand was inserted into the mouth to pass by the cLMA and reach the tip of the cLMA. The tip of cLMA was directed to the caudal by the index finger. Then, cLMA was inserted by the guidance of the index finger until it reached the triangular base of the oropharynx.Results: There was no statistically significant difference in terms of demographic data and placement success; placement success was better in the study group (100% versus 98.6% and P = 0.45). Similarly, the count of attempts was better in the study group. The mean attempt number was 1.11 in group S and 1.28 in group C (P = 0.02). Also, blood on LMA was seen to be more common in group C (P = 0.04). There were no statistical differences in sore throat, but it was less seen in group S.Conclusion: The new maneuver was better than the standard technique and easy to use in daily practice.Keywords: Airway management, Laryngeal mask airway, Complications