Castillo-Monzón Caridad G, Marroquín-Valz Hugo Antonio, Gaszynski Tomasz, Cayuela Manuel, Orozco Javier, Ratajczyk Pawel
Service of Anaesthesiology, Reanimation and Pain Therapy, University General Hospital of Cartagena-Murcia, Cartagena, Spain.
University General Hospital of Cartagena-Murcia, Cartagena, Spain.
Front Med (Lausanne). 2024 Dec 16;11:1469225. doi: 10.3389/fmed.2024.1469225. eCollection 2024.
The Laryngeal Mask Airway Vision Mask (LMA VM) is a supraglottic airway device (SAD) with a vision guidance system. The ideal head and neck position for direct laryngoscopy is known, but the ideal position for placing a LMA is not. The objective of this study is to evaluate and compare the optimal position for placement of a video laryngeal mask airway.
This prospective, observational, transversal, and analytical study was performed in 72 consecutive patients. In the same patient, laryngeal vision was first assessed with the head and neck in the sniffing position and then with the head in the neutral position. Procedures were performed by the same investigator. The assessment of the laryngeal view was performed using two classifications: Cormack-Lehane classification and Brimacombe classification. The placement of the device was considered adequate when the Cormack-Lehane rating was between 1 and 2 and the Brimacombe rating between 2 and 4.
In this study, 72 patients participated. In the assessment of the glottis using the Cormack-Lehane classification for fibre-optic view, laryngeal visibility was adequate in 64 (88.89%) patients in the neutral position and in 65 (90, 28%) patients in the sniffing position ( > 0.05). In the fibre-optic view of the glottis, evaluated using the Brimacombe classification, laryngeal visibility was adequate in 68 (93%) patients in the neutral position and in 69 (95%) patients in the sniffing position ( > 0.05). There was no statistically significant difference in the rate of success between the sniffing position (70 patients, 97.22% success rate) and the neutral position (67 patients, 93.06% success rate) during the first insertion attempt. Two patients required a second attempt in the sniffing position, while five patients required a second attempt in the neutral position.
An adequate sniffing position did not result in a better glottic view than the neutral position. Additional manoeuvres were equal in both positions. The head-neck position does not influence on the placement of a third-generation SAD.
喉罩气道可视面罩（LMA VM）是一种带有可视引导系统的声门上气道装置（SAD）。直接喉镜检查的理想头颈部位置是已知的，但放置喉罩的理想位置尚不清楚。本研究的目的是评估和比较视频喉罩气道放置的最佳位置。
本前瞻性、观察性、横向和分析性研究连续纳入了72例患者。在同一患者中，首先在头颈部处于嗅物位时评估喉部视野，然后在头部处于中立位时评估。操作由同一名研究者进行。使用两种分类方法评估喉镜视野：Cormack-Lehane分类法和Brimacombe分类法。当Cormack-Lehane分级为1至2级且Brimacombe分级为2至4级时，装置放置被认为是合适的。
本研究中，72例患者参与。在使用Cormack-Lehane分类法评估声门的光纤视野时，中立位有64例（88.89%）患者的喉部可视性良好，嗅物位有65例（90.28%）患者的喉部可视性良好（P>0.05）。在使用Brimacombe分类法评估声门的光纤视野时，中立位有68例（93%）患者的喉部可视性良好，嗅物位有69例（95%）患者的喉部可视性良好（P>0.05）。在首次插入尝试期间，嗅物位（70例患者，成功率97.22%）和中立位（67例患者，成功率93.06%）之间的成功率无统计学显著差异。两名患者在嗅物位需要第二次尝试，而五名患者在中立位需要第二次尝试。
与中立位相比，合适的嗅物位并未带来更好的声门视野。在两个位置额外的操作是相同的。头颈部位置不影响第三代SAD的放置。
