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Korean J Anesthesiol > Epub ahead of print
DOI: https://doi.org/10.4097/kja.d.18.00367    [Epub ahead of print]
Published online June 4, 2019.
Comparison of air Q® insertion techniques in pediatric patients with fiberoptic bronchoscopic assessment
Manasa Gaddam, Sameer Sethi, Aditi Jain, Vikas Saini
Postgraduate Institute of Medical Education and Research, India
Corresponding author:  Sameer Sethi,
Received: 24 December 2018   • Revised: 27 May 2019   • Accepted: 28 May 2019
Abstract
Background
Air-QR Laryngeal mask airway [LMA] is a second-generation supraglottic airway device [SAD] that provides adequate airway control in children despite the unfavourable anatomy of the paediatric airway. There are studies assessing it as a conduit for tracheal intubation and comparing the efficacy of the device with other SADs. Till date there are no studies comparing the laryngeal view through air-Q using two insertion techniques i.e., Midline and Rotational technique. Therefore, we planned to compare the fiberoptic bronchoscopic [FOB] assessment of air-Q position using these two insertion techniques.
Methods
In this randomised controlled trial, 80 pediatric patients of American Society of Anesthesiologists [ASA] physical status I /II of either sex, in the age group of 5 to 12 years, weighing 10 to 30 kilograms [kg] who were scheduled for elective surgery in supine position under general anaesthesia were included. The appropriate size of the air-Q based on the weight of the patient was inserted using the technique allocated to the patient.
Results
FOB Grade 1 [ideal position] was seen in 29/40 [72.5%] of children in the Rotational technique and 19/40 [47.5%] children in Classic midline technique [P value 0.04]. Time taken to successfully insert the air Q was significantly less with the rotational technique [7.2 ± 1.5 sec] when compared with the classic midline technique [10.2 ± 2.1 sec] [P value <0.001]. Complications were similar in both the groups.
Conclusions
The rotational technique of insertion of air-Q is associated with better fiberoptic bronchoscopic view and is faster when compared to the Classic Midline technique of insertion of air-Q in paediatric patients.
Key Words: Laryngeal mask airway; Supraglottic airway; Insertion techniques; Air-Q; Laryngeal view; Complications
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