Evaluation of thyromental distance versus tongue width versus weight-based method for size determination of laryngeal mask airway in adults
Background: Supraglottic airway devices (SGD) are indispensable for airway management. The successful placement of the laryngeal mask airway (LMA) supreme largely depends on the right size selection. Aims and Objectives: The study was undertaken to compare three LMA supreme insertion methods in s...
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| Format: | Article |
| Language: | English |
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Manipal College of Medical Sciences, Pokhara
2023-09-01
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| Series: | Asian Journal of Medical Sciences |
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| Online Access: | https://www.nepjol.info/index.php/AJMS/article/view/54148 |
| _version_ | 1797727881476964352 |
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| author | Shalini Jain Priyanka Joshi K K Arora |
| author_facet | Shalini Jain Priyanka Joshi K K Arora |
| author_sort | Shalini Jain |
| collection | DOAJ |
| description | Background: Supraglottic airway devices (SGD) are indispensable for airway management. The successful placement of the laryngeal mask airway (LMA) supreme largely depends on the right size selection.
Aims and Objectives: The study was undertaken to compare three LMA supreme insertion methods in short elective surgeries under general anesthesia.
Materials and Methods: Atotal of 90 American Society of Anesthesiologists I and II patients (either gender, 18–55 years, Mallampati grade I and II) undergoing short surgeries were randomized into three equal groups (n=30 in each). Insertion of LMA was done after an adequate depth of anesthesia for jaw relaxation (Young’s criteria). The efficacy of controlled ventilation through LMA by each method, success rate, ease of insertion, insertion time, additional induction dose (propofol) required during insertion, hemodynamic stability (baseline vitals and 10 min after insertion), and adverse events after LMA removal were evaluated between groups.
Results: Better ventilation (tidal volume at 10 cmH2O) was observed in the thyromental group (448±35) than in tongue width (440±46) and weight-based (409±33) groups. Minimum additional propofol requirement during insertion was in thyromental distance group. Thyromental distance group had the most easy LMA insertions (70%) with minimum insertion time (10±4) and minimum additional propofol requirement during insertion (P<0.05) than other groups. Overall hemodynamic stability and incidence of adverse events were comparable.
Conclusion: Thyromental distance may be an alternative attractive choice for size determination of LMA supreme in female adults with normal airway anatomy in comparison to tongue width and conventional body weight-based methods. |
| first_indexed | 2024-03-12T11:05:54Z |
| format | Article |
| id | doaj.art-d05bf80235b245dd8179f7260e0a3b60 |
| institution | Directory Open Access Journal |
| issn | 2467-9100 2091-0576 |
| language | English |
| last_indexed | 2024-03-12T11:05:54Z |
| publishDate | 2023-09-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj.art-d05bf80235b245dd8179f7260e0a3b602023-09-02T04:03:53ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762023-09-011496975https://doi.org/10.3126/ajms.v14i9.54148Evaluation of thyromental distance versus tongue width versus weight-based method for size determination of laryngeal mask airway in adultsShalini Jain 0https://orcid.org/0000-0001-6702-9666Priyanka Joshi 1https://orcid.org/0009-0009-1732-5454K K Arora 2https://orcid.org/0000-0002-7376-4322Professor, Department of Anaesthesiology, Mahatma Gandhi Medical College, Indore, Madhya Pradesh, India Postgraduate Resident, Department of Anaesthesiology, Mahatma Gandhi Medical College, Indore, Madhya Pradesh, India Professor and Head, Department of Anaesthesiology, Mahatma Gandhi Medical College, Indore, Madhya Pradesh, India Background: Supraglottic airway devices (SGD) are indispensable for airway management. The successful placement of the laryngeal mask airway (LMA) supreme largely depends on the right size selection. Aims and Objectives: The study was undertaken to compare three LMA supreme insertion methods in short elective surgeries under general anesthesia. Materials and Methods: Atotal of 90 American Society of Anesthesiologists I and II patients (either gender, 18–55 years, Mallampati grade I and II) undergoing short surgeries were randomized into three equal groups (n=30 in each). Insertion of LMA was done after an adequate depth of anesthesia for jaw relaxation (Young’s criteria). The efficacy of controlled ventilation through LMA by each method, success rate, ease of insertion, insertion time, additional induction dose (propofol) required during insertion, hemodynamic stability (baseline vitals and 10 min after insertion), and adverse events after LMA removal were evaluated between groups. Results: Better ventilation (tidal volume at 10 cmH2O) was observed in the thyromental group (448±35) than in tongue width (440±46) and weight-based (409±33) groups. Minimum additional propofol requirement during insertion was in thyromental distance group. Thyromental distance group had the most easy LMA insertions (70%) with minimum insertion time (10±4) and minimum additional propofol requirement during insertion (P<0.05) than other groups. Overall hemodynamic stability and incidence of adverse events were comparable. Conclusion: Thyromental distance may be an alternative attractive choice for size determination of LMA supreme in female adults with normal airway anatomy in comparison to tongue width and conventional body weight-based methods.https://www.nepjol.info/index.php/AJMS/article/view/54148laryngeal mask airway; anesthesia; hemodynamic; ventilation; airway; thyromental distance; tongue width; body weight |
| spellingShingle | Shalini Jain Priyanka Joshi K K Arora Evaluation of thyromental distance versus tongue width versus weight-based method for size determination of laryngeal mask airway in adults Asian Journal of Medical Sciences laryngeal mask airway; anesthesia; hemodynamic; ventilation; airway; thyromental distance; tongue width; body weight |
| title | Evaluation of thyromental distance versus tongue width versus weight-based method for size determination of laryngeal mask airway in adults |
| title_full | Evaluation of thyromental distance versus tongue width versus weight-based method for size determination of laryngeal mask airway in adults |
| title_fullStr | Evaluation of thyromental distance versus tongue width versus weight-based method for size determination of laryngeal mask airway in adults |
| title_full_unstemmed | Evaluation of thyromental distance versus tongue width versus weight-based method for size determination of laryngeal mask airway in adults |
| title_short | Evaluation of thyromental distance versus tongue width versus weight-based method for size determination of laryngeal mask airway in adults |
| title_sort | evaluation of thyromental distance versus tongue width versus weight based method for size determination of laryngeal mask airway in adults |
| topic | laryngeal mask airway; anesthesia; hemodynamic; ventilation; airway; thyromental distance; tongue width; body weight |
| url | https://www.nepjol.info/index.php/AJMS/article/view/54148 |
| work_keys_str_mv | AT shalinijain evaluationofthyromentaldistanceversustonguewidthversusweightbasedmethodforsizedeterminationoflaryngealmaskairwayinadults AT priyankajoshi evaluationofthyromentaldistanceversustonguewidthversusweightbasedmethodforsizedeterminationoflaryngealmaskairwayinadults AT kkarora evaluationofthyromentaldistanceversustonguewidthversusweightbasedmethodforsizedeterminationoflaryngealmaskairwayinadults |