Comparison of Ultrasound Examination and Fiberoptic Laryngoscopy for Confirmation of Laryngeal Mask Airway Placement.

Autor: Malik P; Department of Anesthesiology, ABVIMS & Dr. RML Hospital, Delhi, New Delhi, India., Arora N; Department of Anesthesiology, ABVIMS & Dr. RML Hospital, Delhi, New Delhi, India., Kakkar A; Department of Anesthesiology, ABVIMS & Dr. RML Hospital, Delhi, New Delhi, India., Sharma AG; Department of Anesthesiology, ABVIMS & Dr. RML Hospital, Delhi, New Delhi, India., Kaur M; Department of Anesthesiology, ABVIMS & Dr. RML Hospital, Delhi, New Delhi, India.
Jazyk: angličtina
Zdroj: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine [J Ultrasound Med] 2023 Aug; Vol. 42 (8), pp. 1819-1827. Date of Electronic Publication: 2023 Feb 27.
DOI: 10.1002/jum.16203
Abstrakt: Objectives: 1) To compare ultrasound (US) examination and fiberoptic laryngoscopy (FOL) for confirmation of laryngeal mask airway (LMA) placement. 2) To evaluate the necessity for reinsertion of LMA based on FOL.
Methods: This prospective observational study included 100 adult patients of American Society of Anesthesiologists (ASA) Grade I and II, undergoing elective surgery under General Anesthesia requiring Proseal LMA™ placement as an airway device. LMA placement was first confirmed by clinical tests. Clinically acceptable patients were further assessed by US and categorized as acceptable (US-A) or unacceptable (US-U) and again by FOL as (FOL-A and FOL-U). Categorical variables presented in number, percentage (%), and continuous variables presented as mean ± SD and median. Inter-rater kappa agreement was used to find out the strength of agreement of acceptability between FOL and US.
Results: The LMA placement was clinically acceptable in 82% of patients on first attempt. FOL had 63% (FOL-A) acceptable LMA placement as compared with US examination which had 56% (US-A). In 85% of patients, US and FOL findings were in good agreement with each other for LMA placement (κ = 0.690 and P < .05). In all patients of FOL of unacceptable (FOL-U) category (37%), LMA was replaced with endotracheal tube.
Conclusion: US provides a safe, non-invasive, and real-time dynamic assessment with 85% diagnostic accuracy for confirmation of LMA placement as compared with FOL.
(© 2023 American Institute of Ultrasound in Medicine.)
Databáze: MEDLINE
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