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Volume 4 No. 2, April 2009 |
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Clinical
Assessment of the Single Use Supraglottic Airway Devices with a Non
inflatable Cuff (The 'i-gel', SLIPATM) and inflatable Cuff (Soft
Seal Laryngeal Mask) for Elective Surgical Procedures
Department of Anesthesia and intensive care, Faculty of medicine,
Tanta University, Egypt
Aim: To compare the efficacy of the single use supraglottic
airways (SGAs) with a Non inflatable cuff ; The 'i-gel' and,
Streamlined pharynx airway liner airway (SLIPATM ) and inflatable
cuff Soft Seal LM (SSLMA) in patients requiring general anesthesia
during elective surgical procedures. Patients & Methods: One hundred
and twenty patients were randomized into 3 groups. An identical
general anesthesia technique was used in all patients groups.
Patients were excluded if there were risk factors for
gastroesophageal reflux. Ease of use, quality of seal, ventilation,
systolic pressure, and response to insertion, side effects and
operating room time were assessed. Results: All The 'I-gel', SLIPATM
and the SSLMA were easy to insert and ventilate with respective mean
(standard deviation) maximum sealing pressures of (26+6.3), (24+1.5)
and (20+2) cmH2O (P = 0.4). The seal quality in all devices
permitted the use of low flows, 485 +82and 451+30and 402+23 mL min–1
(P = 0.2) respectively, were achieved. Hemodynamic variables in all
SGAs groups were stable in response to insertion and removal, but
there was a lesser difference in incidence of sore throats as
compared with 'i-gel', SLIPA and the SSLMA (8%, 20% vs. 30%), (P
>0.05). SLIPA wase associated with a higher incidence of gastric air
insufflations 10% vs. 5% with the SSLMA and 0% with the 'i-gel'.
With all SGAs, there was no significant difference in operating room
time. Conclusions: The i-gel', SLIPATM and the Soft Seal LM ,were
easy to use without requiring muscle relaxants, and all three
disposable SGAs proved to be suitable for controlled ventilation
during routine surgical operations. The i-gel' and SLIPA are useful
alternative to the Soft Seal LM in patients undergoing minor
surgery. However, SLIPA is associated with a higher incidence of
gastric air insufflations, which may increase the risk of
aspiration. |
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