TY - JOUR
T1 - Gastroesophageal regurgitation during anesthesia and controlled ventilation with six airway devices
AU - Khazin, Vadim
AU - Ezri, Tiberiu
AU - Yishai, Ron
AU - Sessler, Daniel I.
AU - Serour, Francis
AU - Szmuk, Peter
AU - Evron, Shmuel
N1 - Funding Information:
This study was supported in part by Joseph Drown Foundation, Los Angeles, CA.
Copyright:
Copyright 2009 Elsevier B.V., All rights reserved.
PY - 2008/11
Y1 - 2008/11
N2 - Study Objective: To investigate the frequency of gastroesophageal regurgitation and respiratory mechanics during positive pressure ventilation using 5 supraglottic devices or an endotracheal tube (ETT). Design: Prospective, randomized study. Setting: Operating rooms in a university-affiliated hospital. Patients: 180 ASA physical status I and II patients, aged 18 to 65 years old, who underwent elective orthopedic, minor vascular, peripheral plastic, or urologic surgery during general anesthesia. Interventions: Patients were randomly allocated to one of 6 airway device groups (n = 30 each): (1) Cobra Perilaryngeal Airway; (2) Laryngeal Mask Airway (LMA) Classic; (3) LMA Fastrach; (4) LMA ProSeal; (5) laryngeal tube; and (6) ETT (SIMS Portex, Ltd, Hythe, Kent, UK). After insertion of the designated device, the lungs of each nonparalyzed patient were mechanically ventilated. Measurements: Hypopharyngeal pH, peak inspiratory pressures, sealing pressures, and lung compliance were measured. Hypopharyngeal pH lower than 4 was considered a regurgitation event. Main Results: Regurgitation (episodes of pH <4) occurred in between one and 5 patients of each study group, with no statistical difference. Sealing pressures were similar among all the airway device groups. Conclusions: The frequency of gastroesophageal regurgitation in anesthetized, unparalyzed, mechanically ventilated patients was similar in patients whose lungs were ventilated with either the Cobra Perilaryngeal Airway, LMA Classic, Fastrach, ProSeal, laryngeal tube, or ETT.
AB - Study Objective: To investigate the frequency of gastroesophageal regurgitation and respiratory mechanics during positive pressure ventilation using 5 supraglottic devices or an endotracheal tube (ETT). Design: Prospective, randomized study. Setting: Operating rooms in a university-affiliated hospital. Patients: 180 ASA physical status I and II patients, aged 18 to 65 years old, who underwent elective orthopedic, minor vascular, peripheral plastic, or urologic surgery during general anesthesia. Interventions: Patients were randomly allocated to one of 6 airway device groups (n = 30 each): (1) Cobra Perilaryngeal Airway; (2) Laryngeal Mask Airway (LMA) Classic; (3) LMA Fastrach; (4) LMA ProSeal; (5) laryngeal tube; and (6) ETT (SIMS Portex, Ltd, Hythe, Kent, UK). After insertion of the designated device, the lungs of each nonparalyzed patient were mechanically ventilated. Measurements: Hypopharyngeal pH, peak inspiratory pressures, sealing pressures, and lung compliance were measured. Hypopharyngeal pH lower than 4 was considered a regurgitation event. Main Results: Regurgitation (episodes of pH <4) occurred in between one and 5 patients of each study group, with no statistical difference. Sealing pressures were similar among all the airway device groups. Conclusions: The frequency of gastroesophageal regurgitation in anesthetized, unparalyzed, mechanically ventilated patients was similar in patients whose lungs were ventilated with either the Cobra Perilaryngeal Airway, LMA Classic, Fastrach, ProSeal, laryngeal tube, or ETT.
KW - Airway devices: supraglottic
KW - Anesthesia
KW - Gastroesophageal regurgitation
KW - Hypopharyngeal pH
KW - Intubation, intratracheal
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U2 - 10.1016/j.jclinane.2008.05.014
DO - 10.1016/j.jclinane.2008.05.014
M3 - Article
C2 - 19019665
AN - SCOPUS:56449123580
SN - 0952-8180
VL - 20
SP - 508
EP - 513
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
IS - 7
ER -