Evaluation of Head and Neck Position on Oropharyngeal Leak Pressure with Baska Mask and Streamlined Liner of Pharyngeal Airway (SLIPATM): Arandomized Clinical Trial
International Journal of Anesthesia and Clinical Medicine
Volume 5, Issue 5, September 2017, Pages: 36-41
Received: Nov. 2, 2017;
Accepted: Nov. 16, 2017;
Published: Dec. 25, 2017
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Rehab Abdel-Raof Abdel-Aziz, Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Yasser Mohamed Osman, Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University, Alexandria, Egypt
The primary objective was to compare oropharyngeal leak pressures of streamlined liner of pharyngeal airway (SLIPATM) and Baska mask at different head and neck positions. Assessing the fiberoptic view of glottis and ventilation score of both devices in different positions were the secondary objectives. Sixty patients ASA I-II, 18-60 years of either sex scheduled for short ambulatory surgery were included. Patients were randomly assigned in a 1:1 ratio to either the SLIPATM or the Baska mask group. The effect of various head and neck positions was evaluated. Neutral position was maintained first then the patient was repositioned in the following positions: maximal extension, maximal flexion, and maximal rotation to the left. In each position, peak airway pressure and oropharyngeal leak pressure were noted. The ventilation score was assessed and fibreoptic views were noted. In both groups, oropharyngeal leak pressures and peak airway pressure were significantly higher with flexion. The fiberoptic score frequently decreased in flexion but with no effect on the ventilation. In comparison between the two devices, there was no significant change in the fibreoptic view of the glottis at different neck positions. So we concluded that, effective ventilation is possible with both Baska mask and SLIPATM with the head in neutral, flexion, extension, and lateral rotation positions. But care should be taken with extreme flexion and the airway pressures need to be monitored. Baska mask has a better margin of safety than SLIPATM due to better airway sealing pressures.
Rehab Abdel-Raof Abdel-Aziz,
Yasser Mohamed Osman,
Evaluation of Head and Neck Position on Oropharyngeal Leak Pressure with Baska Mask and Streamlined Liner of Pharyngeal Airway (SLIPATM): Arandomized Clinical Trial, International Journal of Anesthesia and Clinical Medicine.
Vol. 5, No. 5,
2017, pp. 36-41.
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Choi GJ, Kang H, Baek CW, Jung YH, Woo YC, Kim SH and Kim JG. Comparison of streamlined liner of the pharynx airway (SLIPATM) and laryngeal mask airway: a systematic review and meta-analysis. Anaesthesia 2015; 70: 613–22.
Miller DM. & Light D. Laboratory and clinical comparisons of the Streamlined Liner of the Pharynx Airway (SLIPATM) with the Laryngeal Mask Airway (LMATM). Anaesthesia 2003; 58(2): 136-42.
Choi YM, Cha SM, Kang H et al. The clinical effectiveness of the streamlined liner of pharyngeal airway (SLIPATM) compared with the laryngeal mask airway ProsealTM during general anesthesia. Korean J Anesthesiol 2010; 58:450-57.
Lange M, Smul TM, Zimmermann P, Roewer N, Kehl F. Comparison of Two Supraglottic Airway Devices: SLIPATM Versus LMATM. Abstracts of papers, Anesthesiology 2006; 105: Abstract A871; http://www.asaabstracts.com (Last accessed 22/11/2011)
Alexiev V, Ochana A, Abdelrahman D, Coyne J, McDonnell JG, Toole DP, NeliganP. Comparison of the Baska_ mask with the single-use laryngeal mask airway in low-risk female patients undergoing ambulatory Surgery. Anaesthesia 2013; 68: 1026–32.
Alexiev V, Salim A, Kevin LG, Laffey JG. An observational study of the Baska_ mask: a novel supraglottic airway. Anaesthesia 2012; 67: 640–5.
Tom VZ, Stephen G. The Baska Mask®—A new concept in Self-sealing membrane cuff extraglottic airway devices, using a sump and two gastric drains: A critical evaluation. Journal of Obstetric Anaesthesia and Critical Care 2012; 2 (1): 23-30.
Mishra SK, Nawaz M, Satyapraksh MVS., Parida S, Bidkar PU, Hemavathy B, and Pankaj Kundra P. Influence of Head and Neck Position on Oropharyngeal Leak Pressure and Cuff Position with the ProSeal Laryngeal Mask Airway and the I-Gel: A Randomized Clinical Trial. Anesthesiol Res Pract 2015:1-7.
Keller C, Brimacombe J, Keller K, Morris R. A comparison of four methods for assessing airway sealing pressure with the laryngeal mask airway in adult patients. Br J Anaesth 1999; 82: 286–7.
Sanuki T, Uda R, Sugioka S, et al. The influence of head and neck position on ventilation with the i-gel airway in paralyzed, anaesthetized patients. Eur J Anaesthesiol 2011: 28(8): 597–99.
Brimacombe JR, Brimacombe JC, Berry AM, et al. A comparison of the laryngeal mask airway and cuffed oropharyngeal airway in anesthetized adult patients. Anesth. Analg 1998; 87(1):147–52.
Somri M, Vaida S, Fornari G, Mendoza GR, et al. A randomized prospective controlled trial comparing the laryngeal tube suction disposable and the supreme laryngeal mask airway: the influence of head and neck position on oropharyngeal seal pressure. BMC Anesthesiology 2016; 16(87) DOI 10.1186/s12871-016-0237-7.
Anand LK, Goel N, Singh M, Kapoor D. Comparison of the Supreme and the ProSeal laryngeal mask airway in patients undergoing laparoscopic cholecystectomy: A randomized controlled trial. Acta Anaesthesiologica Taiwanica 2016; 54: 44-50.
Keller C, Brimacombe J, and Puhringer F. A fibreoptic scoring system to assess the position of laryngeal mask airway devices. Interobserver variability and a comparison between the standard, flexible and intubating laryngeal mask airways. Anasthesiol Intensivmed Notfallmed Schmerzther 2000; 35(11): 692–94.
Park SH, Han SH, Do SH, Kim JW, and Kim JH. The influence of head and neck position on the oropharyngeal leak pressure and cuff position of three supraglottic airway devices. Anesth Analg 2009; 108(1): 112–17.
Xue FS, Mao P, Liu HP, et al. The effects of head flexion on airway seal, quality of ventilation and orogastric tube placement using the ProSealTM laryngeal mask airway. Anaesthesia 2008; 63: 979–85.
Isserles SA. and Rozenberg B. LMA: Reduction of gas leak. Can J Anaesth 1995; 42(5): 449.
Nandi PR, Charlesworth CH, Taylor SJ, Nunn JF, and Dore C J. Effect of general anaesthesia on the pharynx. Br J Anaesth 1991; 66(2): 157–62.