Document Detail


The influence of head and neck position on ventilation with the i-gel airway in paralysed, anaesthetised patients.
MedLine Citation:
PMID:  21505345     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
CONTEXT AND OBJECTIVE: We hypothesised that head and neck position could affect the effectiveness of ventilation with the i-gel airway. To test this hypothesis, we investigated the influence of different head and neck positions on oropharyngeal sealing pressures and ventilation scores during ventilation with i-gel. METHODS: A single, experienced supraglottic airway device user inserted the i-gel in 20 paralysed, anaesthetised patients who were scheduled for oral surgery. Oropharyngeal leak pressures and ventilation scores were measured with the head and neck in the neutral position, flexed, extended or rotated to the right. Ventilation was scored from 0 to 3 based on three criteria (no leakage with an airway pressure of 15 cmH2O, bilateral chest excursion and a square wave capnogram; each item scoring 0 or 1 point). RESULTS: Compared with the neutral position (25.8 ± 5.2 cmH2O), oropharyngeal leak pressure was significantly higher with flexion (28.5 ± 3.4 cmH2O, P = 0.015) and lower with extension (23.0 ± 4.2 cmH2O, P = 0.015), but similar with rotation (26.7 ± 5.1 cmH2O, P = 0.667). Flexion of the head and neck [2 (1-3)] adversely affected the ventilation score compared with the neutral position [3 (2-3), P = 0.004]. CONCLUSION: Effective ventilation with an i-gel can be performed in patients in whom the head and neck is extended or rotated, whereas flexion of the head and neck adversely affects ventilation. Clinically, flexion of the head and neck should be avoided during ventilation with the i-gel.
Authors:
Takuro Sanuki; Rumiko Uda; Shingo Sugioka; Erina Daigo; Hiroki Son; Masafumi Akatsuka; Junichiro Kotani
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-20
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  -     ISSN:  1365-2346     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Department of Anesthesiology, Osaka Dental University (TS, SS, ED, JK), Department of Anesthesia, Hirakata City Hospital (RU, HS, MA), Osaka, Japan.
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