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| Name | Class |
|---|---|
| Ambu A/S | INDUSTRY |
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The aim of the study is to compare the performance of two supraglottic airway devices (SGA), the new Ambu AuraGain and the LMA Supreme, in sixty female patients undergoing gynaecologic laparoscopy in the trendelemburg position.
Primary outcome is the airway seal pressure. Secondary outcomes are ease of insertion, quality of ventilation, endoscopic view of the glottis, gastric tube passage and complications.
The patients are randomly assigned to 2 groups:
Procedure:
The investigation protocol contains the following sections:
Induction of anaesthesia. Intravenous infusion of remifentanil and propofol targeting the effect site (2-4 ng/ml and 4-6 µg/ml respectively). No muscle relaxant will be used for insertion of the SGA. Rocuronium 0.2 mg/Kg will be administered before initiation of pneumoperitoneum.
Insertion of the SGAs. The size of the SGA device used is based on the manufacturers' recommendations. All devices are deflated a lubricated prior to use. Once inserted, the cuff is be inflated with a manometer up to 60 cm H20 Position of the device is adjusted if needed. Data recorded: size of SGA, time an number of attempts.
Fibreoptic evaluation of the SGAs anatomical position: complete view of the vocal cords (I), epiglottis visible inside, but not causing obstruction (II), epiglottis visible and obstructing the glottic inlet (III), or glottic structures not identified (IV).
Functionality of the gastric drainage channel of the SGAs: passage of a 16 G size tube.
Measurement of airway seal pressure (oropharyngeal leak pressure (OLP): at baseline, and at 15, 30 and 60 minutes. The maximum pressure allowed is 40 cm H2O.
Ventilatory mechanics and parameters are measured at baseline, and at 15, 30 and 60 minutes.
Perioperative complications: Hiccup, gastric distension, regurgitation / Aspiration, airway obstruction, laryngospasm, dental, mucosal or tongue injury, hypoxia (SpO2 < 92%)
Removal of the SGAs: Presence of blood - 3 level grading (+/++/+++) Postoperative complications: sore throat, hoarseness, dysphonia, dysphagia, dysphagia: 3-point scale
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ambu AuraGain | Active Comparator | Insertion of the supraglottic device and evaluation of its clinical performance |
|
| LMA Supreme | Active Comparator | Insertion of the supraglottic device and evaluation of its clinical performance |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ambu AuraGain evaluation | Device | Evaluation of clinical performance in terms of Insertion, ventilation, position and complications |
|
| Measure | Description | Time Frame |
|---|---|---|
| Airway seal pressure | Maximum airway pressure that the device can achieve without oropharyngeal leak of gas. | At 15 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Ease of insertion of the device | Time needed to insert the device | Baseline |
| Change in Quality of ventilation | number of manoeuvres/corrections required |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ana M Lopez, MD | Hospital Clinic of Barcelona | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ambulatory Surgery, Hospital Clinic de Barcelona | Barcelona | Barcelona | 08036 | Spain |
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| ID | Term |
|---|---|
| D010535 | Laparoscopy |
| ID | Term |
|---|---|
| D004724 | Endoscopy |
| D003949 | Diagnostic Techniques, Surgical |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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| LMA Supreme evaluation | Device | Evaluation of clinical performance in terms of Insertion, ventilation, position and complications |
|
| Laparoscopic surgery | Procedure | Gynecologic laparoscopic surgery in the trendelemburg position |
|
| At baseline and at 15, 30 and 60 minutes |
| Endoscopic view of glottic structures | Assessment of alignment with the glottic inlet as: complete view of the vocal cords (I), epiglottis visible inside, but not causing any obstruction (II), epiglottis visible and causing obstruction (III) or glottis not identified (IV) | At 15 minutes |
| Gastric tube insertion | Ease of passage of a gastric tube as: easy, difficult or impossible | At 5 minutes |
| Incidence of perioperative complications | number of patients with adverse events: Airway obstruction, desaturation, Aspiration, oropharyngeal trauma, sore throat | 2 hours |
| D019060 | Minimally Invasive Surgical Procedures |
| D013514 | Surgical Procedures, Operative |