The application of intubating laryngeal mask airway guided tracheal intubation in non-anesthesia residents during the rotation of anesthesiology

doi:10.3760/cma.j.issn.1673-677X.2018.06.027

Abstract

Abstract: Objective To investigate the application of intubation laryngeal mask airway in the non-anesthesia residents during rotation of anesthesiology. Methods Thirty non-anesthesia residents in anesthesiology department were selected at Beijing Friendship Hospital of the Capital Medical University. They were required to perform the operation of bag-mask ventilation, laryngoscopic tracheal intubation, and insertion of intubating laryngeal mask airway and tracheal intubation through it. The success rates of insertion were recorded. Residents' perceptions were assessed on both methods. Results Thirty residents successfully placed the laryngeal mask for ventilation. Tracheal intubation along intubating laryngeal mask airway was successfully performed in 93.3%(28/30) patients as compared with 63.3% (19/30) in group of direct laryngoscopy (χ²=14.0, P<0.05). It showed that residents preferred intubating laryngeal mask airway more to traditional direct laryngoscopy for providing better learning skills with statistical differences (all P<0.05). Conclusions The use of intubating laryngeal mask can help non-anesthesia residents being trained with better intubation skills in the clinical rotation of anesthesiology.

Key words: Intubating laryngeal mask, Endotracheal intubation, Non-anesthesia residents

Qiu Huanrong, Hong Fangxiao, Tian Ming, Xue Fushan. The application of intubating laryngeal mask airway guided tracheal intubation in non-anesthesia residents during the rotation of anesthesiology[J]. Chinese Journal of Medical Education, 2018, 38(6): 921-924.

References

[1] 中华医学会麻醉学分会. 困难气道管理专家共识[J].临床麻醉学杂志,2009,25(3):200-203.
[2] Young B. The intubating laryngeal-mask airway may be an ideal device for airway control in the rural trauma patient[J]. Am J Emerg Med, 2003,21(1):80-85. DOI: 10.1053/ajem.2003.50012.
[3] 李莉, 王凤明. 喉罩在临床中的应用[J].吉林医学,2003,24(4):340.
[4] Ibrahim NK, Banjar S, Al-Ghamdi A, et al. Medical students preference of problem-based learning or traditional lectures in King Abdulaziz University, Jeddah, Saudi Arabia[J]. Ann Saudi Med, 2014,34(2):128-133. DOI: 10.5144/0256-4947.2014.128.
[5] Mulcaster JT, Mills J, Hung OR, et al. Laryngoscopic intubation: Learning and performance[J]. Anesthesiology, 2003,98(1):23-27.
[6] Tiah L, Wong E, Chen MF, et al. Should there be a change in the teaching of airway management in the medical school curriculum[J] ? Resuscitation, 2005,64(1):87-91. DOI: 10.1016/j.resuscitation.2004.07.011.
[7] Weksler N, Tarnopolski A, Klein M, et al. Insertion of the endotracheal tube, laryngeal mask airway and oesophageal-tracheal Combitube. A 6-month comparative prospective study of acquisition and retention skills by medical students[J]. Eur J Anaesthesiol, 2005,22(5):337-340.
[8] Heidegger T. Airway management: Standardization, simplicity, and daily practice are the keys to success[J]. Anesth Analg, 2010,111(4):1073-1074. DOI: 10.1213/ANE.0b013e3181ec312a.
[9] Kurola J, Pere P, Niemi-Murola L, et al. Comparison of airway management with the intubating laryngeal mask, laryngeal tube and CobraPLA by paramedical students in anaesthetized patients[J]. Acta Anaesthesiol Scand, 2006,50(1):40-44. DOI: 10.1111/j.1399-6576.2005.00852.x.
[10] Levitan RM, Ochroch EA, Stuart S, et al. Use of the intubating laryngeal mask airway by medical and nonmedical personnel[J]. Am J Emerg Med, 2000,18(1):12-16.
[11] Choyce A, Avidan MS, Patel C, et al. Comparison of laryngeal mask and intubating laryngeal mask insertion by the nave intubator[J]. Br J Anaesth, 2000,84(1):103-105.
[12] Timmermann A, Russo SG, Crozier TA, et al. Laryngoscopic versus intubating LMA guided tracheal intubation by novice users: A manikin study[J]. Resuscitation, 2007,73(3):412-416. DOI: 10.1016/j.resuscitation.2006.10.019.
[13] Reeves MD, Skinner MW, Ginifer CJ. Evaluation of the intubating laryngeal mask airway used by occasional intubators in simulated trauma[J]. Anaesth Intensive Care, 2004,32(1):73-76.
[14] 张帅, 周婧, 张晔, 等. 全身麻醉诱导后经多功能插管型喉罩盲探气管插管的临床观察[J].国际麻醉学与复苏杂志,2016,37(10):917-920,924. DOI: 10.3760/cma.j.issn.1673-4378.2016.10.012.
Zhang S, Zhou J, Zhang Y, et al.Application of blind orotracheal intubation via BlockBuster laryngeal mask in patients undergoing general anesthesia[J].Int J Anesth Resus,2016,37(10):917-920,924. DOI: 10.3760/cma.j. issn.1673-4378.2016.10.012.
[15] 左明章, 闫春伶. 困难气道管理新进展[J].北京医学,2016,38(6):499-500. DOI: 10. 15932 /j. 0253-9713. 2016.6.001.
[16] 熊志添, 黄河山, 许学兵. 喉罩在麻醉和气道管理中的地位[J].中华麻醉学杂志,2002,22(8):508-512.