|LETTER TO EDITOR
|Year : 2017 | Volume
| Issue : 2 | Page : 532-533
A modified insertion technique of ambu AuraGain™ laryngeal airway, a third-generation supraglottic airway to reduce the oral mucosal injury
Sandeep Kumar Mishra, Prasanna Udupi Bidkar, Lenin Babu Elakkumanan, Satyen Parida
Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
|Date of Web Publication||16-May-2017|
Sandeep Kumar Mishra
Qr. No. D (II) 10, JIPMER Campus, Dhanvantari Nagar, Puducherry - 605 006
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mishra SK, Bidkar PU, Elakkumanan LB, Parida S. A modified insertion technique of ambu AuraGain™ laryngeal airway, a third-generation supraglottic airway to reduce the oral mucosal injury. Anesth Essays Res 2017;11:532-3
|How to cite this URL:|
Mishra SK, Bidkar PU, Elakkumanan LB, Parida S. A modified insertion technique of ambu AuraGain™ laryngeal airway, a third-generation supraglottic airway to reduce the oral mucosal injury. Anesth Essays Res [serial online] 2017 [cited 2020 Jul 6];11:532-3. Available from: http://www.aeronline.org/text.asp?2017/11/2/532/206277
Ambu AuraGain TM is a new single-use supraglottic airway (SGA) device available in adult size 3, 4, and 5. It is an anatomically curved SGA with integrated gastric access and can be used as a conduit for direct endotracheal intubation assisted by a flexible scope. The standard recommended insertion technique is as that of intubating laryngeal mask airway (LMA), i.e., keeping the handle (Shaft) approximately parallel to the patient's chest and then pushing the device along the hard palate after opening the mouth [Figure 1]a. With the previous experience of other faculty and residents with this device in our institute, we noticed that a higher tangential force is required for the placement due to bulky and acute angle of the device. Due to difficulty in insertion, few cases also resulted in oral mucosal injury in the form of bleeding and ulceration with inadequate sealing and higher airway pressure.
|Figure 1: Ambu AuraGain™ (a: Standard recommended insertion, b: Modified insertion technique)|
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One of the advantages of Ambu AuraGain laryngeal airway is that it can be straightened to that like that of Classic or ProSeal LMA [Figure 1]b. We found that the guiding with the tip of the finger as that of classical LMA is more easy and convenient and required minimal pressure to overcome the resistance of the hard palate and posterior pharyngeal wall. After insertion with this technique, we are getting an effective oropharyngeal seal with a leak airway pressure of 25–30 cm of H2O and peak airway pressure and tidal exchange within normal limit for the patient. At present, various studies are going on with this device in our institute where we prefer this method of insertion of this device compare to the conventional technique. Therefore, we advocate using this method routinely and in situ ations when there is difficulty in placement of this device.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Lopez A, Sala-Blanch X, Valero R, Prats A. Cross-over assessment of the Ambu AuraGain, LMA Supreme New Cuff and Intersurgical I-Gel in fresh cadavers. Open J Anesthesiol 2014;4:332-9.
Brain AI, Verghese C, Addy EV, Kapila A. The intubating laryngeal mask. I: Development of a new device for intubation of the trachea. Br J Anaesth 1997;79:699-703.