The effectiveness of the Ambu® AuraGain™ laryngeal mask on hemodynamic and respiratory parameters in patients undergoing septoplasty: A randomized prospective clinical study

Abstract

Background/Aim: The use of laryngeal masks is increasing with the introduction of 3rd generation airway vehicles. However, endotracheal intubation is preferred by most anesthesiologists in septoplasty operations due to airway safety concerns. In this study, we aimed to compare the 3rd generation airway device, Ambu® Auragain ™ LMA, with tracheal intubation in terms of hemodynamic and respiratory parameters. Methods: This study included 69 patients aged 18–60 years with an ASA score of 1–2 who were scheduled for septoplasty in Adıyaman University Research and Educational Hospital between 2016.01.01 and 2017.06.31. Study groups were randomly defined as Group 1 - Ambu® AuraGain™ laryngeal mask (LMA, n = 37) and Group 2 - endotracheal intubation (ETT, n = 32), and the hemodynamic and respiratory parameters were measured and recorded. Results: The demographic data and partial oxygen saturation of the patients were similar (P>0.05 for all values). The patients in the ETT group had a higher heart rate at induction, intubation and at the first minute compared to the LMA group (P<0.05 for all values). The mean arterial pressure was significantly lower at induction, intubation, at minutes 1, 2, 3, and 4 of intubation, and at extubation in the LMA group (P<0.05 for all values). Conclusion: The Ambu® AuraGain™ laryngeal mask was similar to or better than tracheal intubation in terms of hemodynamic and respiratory parameters. The Ambu® AuraGain™ LMA can be used as an equivalent to tracheal intubation in terms of hemodynamic and respiratory parameters.

Keywords

• Ambu® AuraGain™ laryngeal mask
• Tracheal intubation
• Septoplasty

Kaynakça

1. 1. Parikh DA, Jain RA, Lele SS, Tendolkar BA. A cohort evaluation of clinical use and performance characteristics of Ambu® AuraGain™: A prospective observational study. Indian J Anaesth. 2017 Aug;61(8):636-42. doi: 10.4103/ija.IJA_285_17. PMID: 28890558; PMCID: PMC5579853.
2. 2. Moser B, Audigen L, Keller C, Brimacombe J, Lukas Gasteiger L, Bruppacher HR, Flexible bronchoscopic intubation through the AuraGainTM laryngeal mask versus a slit Guedel tube: a non-inferiority randomized-controlled trial. Can J Anesth/J Can Anesth. 2017;64:1119–28. doi: 10.1007/s12630-017-0936-7
3. 3. Ahmad I, Bailey CR. Time to abandon awake fibreoptic intubation? Anaesthesia. 2016;71:12-6.
4. 4. Che Omar S, Hardy Mohamad Zaini R, Fui Wong T, Nazaruddin W, Hassan WM. Comparison of the Air-Q intubating laryngeal mask airway and the Ambu AuraGain laryngeal mask airway as a conduit for fibreoptic assisted endotracheal intubation for simulated cervical spine injury. Anaesthesiol Intensive Ther. 2021 May 19:43956. doi: 10.5114/ait.2021.105759. Epub ahead of print. PMID: 34006053.
5. 5. Karaaslan E, Akbas S, Ozkan AS, Colak C, Begec Z. A comparison of laryngeal mask airway-supreme and endotracheal tube use with respect to airway protection in patients undergoing septoplasty: a randomized, single-blind, controlled clinical trial. BMC Anesthesiol. 2021 Jan 7;21(1):5. doi: 10.1186/s12871-020-01222-4. PMID: 33407130; PMCID: PMC7789562.
6. 6. Al-Mazrou KA, Abdullah KM, El Gammal MS, Ansari RA, Turkistani A, Abdelmeguid ME. Nazal ve paranazal sinüs cerrahisi için gırtlak maskesi hava yolu ile kelepçesiz endotrakeal tüp: pediatrik hava yolu koruması. Eur J Anaesthesiol. 2010;27(1):16-9.
7. 7. Lee HJ, Jank YE, Kim EH, Kim HS, Kim J. Flexion decreases the ventilation quality of the Ambu® AuraGain™ laryngeal mask in paralysed children: A prospective randomised crossover study. Acta Anaesthesiologica Scandinavica. 2018;62(8):1080-5.
8. 8. Mihara T,Nakayama R, Ka K, Goto T. Comparison of the clinical performance of i-gel and Ambu AuraGain in childrenEuropean Journal of Anesthesiology. 2019;36(6):411-17. doi: 10.1097 / EJA.0000000000000987.

9. 9. Uthaman D, Gupta SL, Mishra SK, et al. Effect of immobilised cervical spine on oropharyngeal sealing pressure with Ambu AuraGain™ Supraglottic airway: A randomised crossover trial. Indian J Anaesth. 2019;63(5):388-93. doi: 10.4103/ija.IJA_787_18
10. 10. Berthold Moser B, Keller C, Audige L, Dave MH, Bruppaccer HR, Fiberoptic intubation of severely obese patients through supraglottic airway: A prospective, randomized trial of the Ambu® AuraGain™ laryngeal mask vs the i‐gel™ airway. Acta Anaesthesiologica Scandinavica. 2019;63(2):187-94.
11. 11. Singh K, Gurha P. Comparative evaluation of Ambu AuraGain™ with ProSeal™ laryngeal mask airway in patients undergoing laparoscopic cholecystectomy. İndian Journal of Anesthesia 2017;61(6):469-74.
12. 12. Moser B, Audigé L, Keller C, Brimacombe J, Gasteiger L, Bruppacher HR. A prospective, randomized trial of the Ambu AuraGain™ laryngeal mask versus the LMA® protector airway in paralyzed, anesthetized adult men. Minerva Anestesiol. 2018 Jun;84(6):684-692. doi: 10.23736/S0375-9393.17.12254-6. Epub 2017 Nov 17. PMID: 29152934.
13. 13. Gasteiger L, Bruppacher HR. A prospective, randomized trial of the Ambu AuraGain™ laryngeal mask versus the LMA® protector airway in paralyzed, anesthetized adult men. Minerva Anestesiol. 2018 Jun;84(6):684-692. doi: 10.23736/S0375-9393.17.12254-6.Epub 2017 Nov 17. PMID: 29152934
14. 14. Schiewe R, Stoeck M, Gruenewald M, Hoecker J, Bein B. A comparison of blind intubation with the intubating laryngeal mask FASTRACH™ and the intubating laryngeal mask Ambu Aura-i™ a prospective randomised clinical trial. BMC Anesthesiol. 2019 Mar 30;19(1):44. doi: 10.1186/s12871-019-0718-6. PMID: 30927922; PMCID: PMC6441151
15. 15. Sabuncu U, Kusderci HS, Oterkus M, Abdullayev R, Demir A, MD, Uludag O, et al. AuraGainTM and i-Gel laryngeal masks in general anesthesia for laparoscopic cholecystectomy. Saudi Med J 2018;39(11):1082-9. doi: 10.15537/smj.2018.11.22346
16. 16. Safaeian R, Hassani V, Movasaghi G, Alimian M, Faiz HR. Postoperative Respiratory Complications of Laryngeal Mask Airway and Tracheal Tube in Ear, Nose and Throat Operations. Anesth Pain Med. 2015 August; 5(4): e25111. DOI: 10.5812/aapm.25111
17. 17. Kim DH, Lee J, Kim SW, Hwang SH. The Efficacy of Hypotensive Agents on Intraoperative Bleeding and Recovery Following General Anesthesia for Nasal Surgery: A Network Meta-Analysis. Clinical and Experimental Otorhinolaryngology 2021;14(2): 200-209. doi: https://doi.org/10.21053/ceo.2020.00584
18. 18. Reid JW, Rotenberg BW, Sowerby LJ. Contemporary decongestant practices of Canadian otolaryngologists for endoscopic sinus surgery. J Otolaryngol Head Neck Surg. 2019 Mar 18;48(1):15. doi: 10.1186/s40463-019-0337-8. PMID: 30885260; PMCID: PMC6421656.