MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,623

eTOC

Minerva Anestesiologica 2018 Mar 27

DOI: 10.23736/S0375-9393.18.12579-X

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Influence of head and neck position on performance of the Ambu® AuraGainTM laryngeal mask: a randomised crossover study

Seokha YOO, Sun-Kyung PARK, Won Ho KIM, Min HUR, Jae-Hyon BAHK, Young-Jin LIM, Jin-Tae KIM ✉

Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea

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BACKGROUND: The purpose of this study was to investigate the influence of different head and neck positions on the performance of the Ambu® AuraGainTM, a novel laryngeal mask with anatomical curvature.
METHODS: Oropharyngeal leak pressure, expiratory tidal volume, peak inspiratory pressure, ventilation score, and fibreoptic view score through the AuraGainTM were measured in the neutral, flexed, and extended neck positions as well as the right rotated head and neck position in each patient in a random order. A total of 40 patients were enrolled, and data from 39 patients were analysed.
RESULTS: Oropharyngeal leak pressure was significantly higher in the flexed neck position (32.1±7.2 cmH2O, 95% CI of mean difference [3.3 to 7.8], P<0.001) and lower in the extended neck position (22.0±6.8 cmH2O, 95% CI of mean difference [−7.0 to −2.0], P=0.001) compared with those in the neutral position (26.6±7.5 cmH2O). The ventilation score was comparable in all positions. The fibreoptic view score was higher in the extended neck position (P<0.001) and right rotated head and neck position (P<0.001) compared with that in the neutral position; the vocal cords were most easily visualized in the extended neck position.
CONCLUSIONS: Head and neck positions affect the oropharyngeal seal of the AuraGainTM, as evidenced by the oropharyngeal leak pressure, but not enough to impede positive-pressure ventilation. Neck flexion can be used when a better oropharyngeal seal is needed, and neck extension and right rotation of the head and neck may facilitate endotracheal intubation using the AuraGainTM as a conduit.

KEY WORDS: Laryngeal masks - Posture - Positive-pressure respiration - Bronchoscopy