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Supraglottic airway devices (SAD) provide ventilation of patients requiring respiratory support without tracheal intubation. Therefore, SAD is used to maintain airway during anesthesia in surgeries that do not require intubation. The classical laryngeal mask (cLMA, Intavent Direct, Maidenhead, UK) is an SAD that is available as a more advanced airway method than mask ventilation and a less invasive method than endotracheal intubation. It is used by placing it over the glottis at the level of the larynx and inflating the cuff. The Proseal laryngeal mask (LMA-Prosealâ„¢, PLMA, Intavent Orthofix, Maidenhead, UK) is the first supraglottic airway device that is suitable for reuse and includes a gastric drainage channel. I-gelâ„¢ (Intersurgical Ltd, Wokingham, UK) is a second-generation laryngeal mask with a soft, gel-like thermoplastic elastomer distal end and no inflatable cuff, designed not to compress the anatomical structures of the larynx and pharynx.
Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) has become one of the most important invasive diagnostic procedures for pulmonologists and thoracic surgeons. It is a safe and effective technique for sampling hilar and mediastinal lymph nodes and masses. It is currently accepted as the first choice for histological sampling of the mediastinum in lung cancer staging.
The use of SAD to secure the airway in patients undergoing EBUS-TBNA has the advantages of being less invasive than endotracheal intubation and providing better surgical field access.
Classical LMA, proseal LMA and I-gel are routinely used airway methods during EBUS-TBNA procedure.
The aim of this study is to compare the routinely used SADs in anesthesia management in patients undergoing endobronchial ultrasonography-guided transbronchial needle aspiration in terms of intraoperative efficacy and postoperative complications.
The parameters to be recorded are: demographic characteristics of the patients, hemodynamic data during and after the procedure, ventilation variables (tidal volume, airway pressures, leak volume), the number of attempts to place the SAD, the need for intubation, the presence of sore throat, nausea and vomiting after the procedure. In addition, the operator performing the procedure will be asked to evaluate the convenience of the procedure.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group I | Airway is secured with LMA classic |
| |
| Group II | Airway is secured with LMA proseal |
| |
| Group III | Airway is secured with I-gel |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| LMA classic | Device | Airway is secured with LMA clasic |
| |
| LMA Proseal |
| Measure | Description | Time Frame |
|---|---|---|
| Quality of fiberoptic view | The operator will score the view of the glottic opening according to the Cormack Lehanne score | 3 minutes after anesthesia induction |
| Measure | Description | Time Frame |
|---|---|---|
| Ease of passage through glottic opening | The operator will score theEase of passage through glottic opening according to a Likert scale | 3 minutes after anesthesia induction |
| Ease of SAD insertion |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients undergoing Endobronchial ultrasound guided transbronchial needle aspiration
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| Name | Affiliation | Role |
|---|---|---|
| Derya Güzelkaya, Dr | Ankara Etlik City Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Etlik City Hospital | Ankara | Ankara | 06010 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27555181 | Background | Maitra S, Baidya DK, Arora MK, Bhattacharjee S, Khanna P. Laryngeal mask airway ProSeal provides higher oropharyngeal leak pressure than i-gel in adult patients under general anesthesia: a meta-analysis. J Clin Anesth. 2016 Sep;33:298-305. doi: 10.1016/j.jclinane.2016.04.020. Epub 2016 May 18. | |
| 33687002 | Background |
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| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| ID | Term |
|---|---|
| D012140 | Respiratory Tract Diseases |
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| Device |
Airway is secured with LMA proseal |
|
| I-gel | Device | Airway is secured with I-gel |
|
The anesthetist will score the ease of SAD insertion a 5 point scale
| 2 minutes after anesthesia induction |
| Complications | Airway trauma as indicated with blood stain on SAD or visible bleeding in the airway | 1 minute after extubation |
| Goel MK, Kumar A, Maitra G, Singh B, Ahlawat S, Jain P, Garg N, Verma RK. Safety and diagnostic yield of transbronchial lung cryobiopsy by flexible bronchoscopy using laryngeal mask airway in diffuse and localized peripheral lung diseases: A single-center retrospective analysis of 326 cases. Lung India. 2021 Mar-Apr;38(2):109-116. doi: 10.4103/lungindia.lungindia_220_20. |