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Thierbach A. 1, Piepho T. 2, Göbler S. 2, Rützler K. 3, Frass M. 4, Kaye A. D. 5, Robak O. 4
1 Department of Anesthesia, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Klinikum Idar-Oberstein, Germany;
2 Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University Mainz, Germany;
3 Department of Anesthesiology and General Intensive Care, Medical University, Vienna, Austria;
4 Department of Medicine I, Medical University of Vienna, Austria;
5 Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, USA
BACKGROUND: Supraglottic airway devices (SAD) provide an effective way for managing difficult airways. Numerous SADs have been developed in recent years. We compared three SADs utilizing simulated airways. The major aim of this study was to provide evidence for the efficacy of SADs in the management of simulated difficult airway situations.
METHODS: The study utilized an airway simulation manikin (Laerdal SimMan® 3G) to assess feasibility and time to final placement of three different airway devices (the classic laryngeal mask airway [LMA], the Laryngeal tube [LT], and the EasyTube® [EzT]). Thirty anesthesiologists inserted each of the SADs under standard physiologic airway conditions (STD) as well as pathological airway conditions, including tongue edema (TE) and trismus combined with limited mobility of the cervical spine (TCS), mimicking a patient with cramps.
RESULTS: In STD and TE, all participants were able to successfully place the LMA, LT, and EzT correctly. In TCS, one participant failed to place the LMA correctly, whereas six participants failed to place the LT correctly (P=0.031). Under STD and TE conditions, we found a significantly longer time to final placement with the EzT (P=0.001). Under TCS conditions, there was no significant difference between the tested SADs. Under STD conditions, the participants rated the LMA best (P<0.001). Under TE and TCS condition, the EzT was significantly higher rated (P<0.001).
CONCLUSION: The EzT showed benefits in two difficult airway situations (TE and TCS) in a prospective manikin study amongst anesthesiologists.