Guided insertion of the ProSeal laryngeal mask airway is superior to conventional tracheal intubation by first-month anaesthesia residents after brief manikin-only training

Hohlrieder, Mathias, Brimacombe, Joseph, von Goedecke, Achim, and Keller, Christian (2006) Guided insertion of the ProSeal laryngeal mask airway is superior to conventional tracheal intubation by first-month anaesthesia residents after brief manikin-only training. Anesthesia and Analgesia, 103 (2). pp. 458-642.

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Abstract

In the following pilot study, we compared conventional laryngoscope-guided tracheal intubation (tracheal intubation) and laryngoscope-guided, gum elastic bougie-guided ProSeal laryngeal mask airway insertion (guided ProSeal) for airway management by first-month anesthesia residents after brief manikin-only training. Five first-month residents with no practical experience of airway management were observed performing these techniques in 200 ASA I–II anesthetized, paralyzed adults. Each resident managed 40 patients, 20 in each group, in random order. The number of insertion attempts, effective airway time, ventilatory capability during pressure-controlled ventilation set at 15 cm H2O, airway trauma, and skill acquisition were studied. Data were collected by unblinded observers. Insertion was more frequently successful (100% versus 65%) and effective airway time was shorter (41 ± 24 s versus 89 ± 62 s) in the guided ProSeal group (both P < 0.0001). Expired tidal volume was larger (730 ± 170 mL versus 560 ± 140 mL) and end-tidal CO2 lower (33 ± 4 mm Hg versus 37 ± 5 mm Hg) in the guided ProSeal group during pressure controlled ventilation (both P < 0.0001). Blood staining was more frequent on the laryngoscope (24% versus 2%; P < 0.0001) in the tracheal intubation group. There was evidence for skill acquisition in both groups. We conclude that laryngoscope-guided, gum elastic bougie-guided insertion of the ProSeal laryngeal mask airway is superior to conventional laryngoscope-guided tracheal intubation for airway management in terms of insertion success, expired tidal volume, and airway trauma by first-month anesthesia residents after brief manikin-only training. The guided ProSeal technique has potential for cardiopulmonary resuscitation by novices when conventional intubation fails.

Item ID: 4047
Item Type: Article (Research - C1)
ISSN: 1526-7598
Keywords: laryngeal mask airway; ProSeal; manikin training; tracheal intubation
Date Deposited: 12 Nov 2009 01:32
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110301 Anaesthesiology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 100%
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