Descriptive study of ultrasound images of the upper airway obtained after insertion of laryngeal mask

• Published in: Revista española de anestesiología y reanimación Vol. 65; no. 8; pp. 434 - 440
• Main Authors: Pérez-Herrero, M A, de la Varga, O, Flores, M, Sánchez-Ruano, J, Otero, M, Buisán, F
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01.10.2018
• Subjects: Upper airway management; Manejo de vía aérea superior; Dispositivos supraglóticos; Ecografía; Ultrasound; Extraglottic devices
• ISSN: 2340-3284; 2341-1929
• DOI: 10.1016/j.redar.2018.05.004

To evaluate clinical usefulness of ultrasound images of the upper airway in order to check correct laryngeal mask placement. A prospective observational study was conducted on patients scheduled for abdominal surgery under general anaesthesia, in whom the patency of the upper airway was ensured using an Ambu AuraGain laryngeal mask. An ultrasound scan was performed of the upper-airway in the cranio-caudal direction and with longitudinal scans in the anterior midline and parasagittal axis, in three moments: before, after inserting and after removing the mask. All recorded images were evaluated in a second time by a radiologist-expert in upper airway ultrasound. Subsequently, the ultrasound data were related to the clinical difficulty of the insertion and presence of air leaks. Data was collected from 30 patients (20 females and 10 males) being operated on for abdominal hysterectomy (15), eventroplasty (6), uterine myomectomy (3), and umbilical (4) and inguinal herniorrhaphy (2). The blind insertion of the masks did not present difficulties in 24 (80%) patients. Air leakage was detected in 8 (26.7%) patients, which was moderate in 7 cases and severe in one of them. The ultrasound findings confirmed good mask placement in 22 (73.3%) patients. Anatomical airway changes after laryngeal mask extraction were only observed in 3 (12%) patients, all of them minor. There was a statistically significant association (P<.05) between difficulty in inserting the device and the level of air leakage. Upper airway ultrasound is a useful diagnostic method to evaluate laryngeal mask placement. Laryngeal oedema was not observed after removal of the device.