Gastroesophageal regurgitation during anesthesia and controlled ventilation with six airway devices

Vadim Khazin, Tiberiu Ezri, Ron Yishai, Daniel I. Sessler, Francis Serour, Peter Szmuk, Shmuel Evron

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)508-513
Number of pages6
JournalJournal of Clinical Anesthesia
Volume20
Issue number7
DOIs
StatePublished - Nov 2008

Fingerprint

Ventilation
Anesthesia
Laryngeal Masks
Equipment and Supplies
Elapidae
Pressure
Respiratory Mechanics
Lung Compliance
Lung
Positive-Pressure Respiration
Operating Rooms
General Anesthesia
Plastics
Orthopedics
Blood Vessels
Prospective Studies

Keywords

  • Airway devices: supraglottic
  • Anesthesia
  • Gastroesophageal regurgitation
  • Hypopharyngeal pH
  • Intubation, intratracheal

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Gastroesophageal regurgitation during anesthesia and controlled ventilation with six airway devices. / Khazin, Vadim; Ezri, Tiberiu; Yishai, Ron; Sessler, Daniel I.; Serour, Francis; Szmuk, Peter; Evron, Shmuel.

In: Journal of Clinical Anesthesia, Vol. 20, No. 7, 11.2008, p. 508-513.

Research output: Contribution to journalArticle

Khazin, Vadim ; Ezri, Tiberiu ; Yishai, Ron ; Sessler, Daniel I. ; Serour, Francis ; Szmuk, Peter ; Evron, Shmuel. / Gastroesophageal regurgitation during anesthesia and controlled ventilation with six airway devices. In: Journal of Clinical Anesthesia. 2008 ; Vol. 20, No. 7. pp. 508-513.
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abstract = "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.",
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