The triple airway manoeuvre for insertion of the laryngeal mask airway in paralyzed patients

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
K AoyamaA Shigematsu

Abstract

The efficacy of the triple airway manoeuvre (mouth opening, head extension and jaw thrust) for insertion of the laryngeal mask airway (LMA) was compared with the standard insertion method. One hundred paralyzed patients were allocated randomly into two groups: in the control group (n = 50) the LMA was inserted by the standard method, and in the other (TAM group, n = 50) by the triple airway manoeuvre. In ten patients of each group, the position of the LMA and the epiglottis was assessed radiographically before insertion, after insertion but before cuff inflation, and after cuff inflation. In all patients the position was examined using fibrescopy before and after cuff inflation. The mean distance between the epiglottis and the posterior pharyngeal wall, measured radiographically before LMA insertion, was greater in the TAM group (16.3 (SD 4.3) mm) than in the control group (7.0 (2.8) mm) (P < 0.001). Before cuff inflation, radiography and fibrescopy showed that the LMA compressed the epiglottis downwards more frequently in the control group. After cuff inflation the glottis was completely visible fibreoptically in 66% in the TAM group, compared with 14% in the control group (P < 0.001). Complete downfolding of the epiglottis wa...Continue Reading

References

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Citations

Oct 1, 1996·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·K AoyamaA Shigematsu
Sep 29, 2001·Anaesthesia·K AoyamaI Takenaka
Feb 22, 2008·Anaesthesia·J J Henderson, A Suzuki
Oct 1, 2016·Journal of Clinical Anesthesia·Kaicheng SongYuguang Huang
Sep 10, 2016·Anaesthesia·A A J van Zundert, K Wyssusek
Feb 17, 2017·British Journal of Anaesthesia·A A J Van ZundertT C R V Van Zundert
Jan 9, 2020·European Journal of Anaesthesiology·Hyunyoung Lim, Mi Ae Jeong
Apr 7, 2019·Journal of Clinical Monitoring and Computing·André A J van ZundertChandra M Kumar
Mar 17, 2020·Journal of Anaesthesiology, Clinical Pharmacology·Kinshuki JainSushma Bhatnagar
Jun 17, 2020·Journal of Clinical Monitoring and Computing·André A J Van ZundertJaideep J Pandit

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