Hyomental Distance Measured Ultrasonography versus weight-based criteria for laryngeal mask size selection in children. A prospective, Randomised Observational Study - Trial PACTR202306740935710

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Summary

The feasibility of using ultrasound examination to confirm LMA placement had been compared with clinical tests and fiberoptic laryngoscopy in females scheduled for gynecologic surgery. The placement was confirmed as acceptable in 89.1% by clinical tests, 59.4% by fiberoptic laryngoscope assessment and 67.2% by ultrasound examination. Concerning patients classified with high oropharyngeal leaks, there were no differences in confirmation of acceptable placement between clinical tests and ultrasound examinations, but the number of patients determined to have acceptable placement by ultrasound examination was greater than that determined by fiberoptic laryngoscopy. The study concluded that ultrasound examination is a superior technique for confirming the seal on the LMA.This prospective, observational study aims to assess the efficacy and safety of ultrasonographic measured hyomental distance in the optimization of LMA placement in pediatric patients.- In pediatric surgery and emergencies, LMA represents a useful airway management device for routine and difficult airway management.- Inserting an improper LMA size may result in malposition, displacement within the hypopharynx, and failed ventilation that needs repositioning.- Selection of the size of LMA represents a major challenge for anesthesiologists, especially in children.- The ultrasonographic measured hyomental distance showed a correlation with the length of the pharyngeal cavity.- Optimization of the size of the inserted LMA can be confirmed either clinically, ultrasonographic or through the fiberoptic laryngoscope.- The ultrasonographic measured hyomental distance confirmed the optimization of LMA with results comparable to that of the clinical methods and better than those of the fiberoptic laryngoscope.OBJECTIVES1) To assess the airway of all included children; clinically and ultrasonographic.2) To measure the hyomental distance ultrasonographically before and after insertion of the LMA.3) Select the size of LMA according to the patient’s weight as recommended by producers.4) To assess the state of ventilation of the patient after insertion of the LMA.5) To assess the position of the inserted LMA in the pharyngeal cavity during anaesthesia.6) To correct any malposition or displacement of the inserted LMA according to the measured hyomental distance.7) To reassess the state of ventilation and position of the LMA after correction.8) To tabulate and analyze the collected data.

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