To compare the influence of blind insertion and up-down optimized glottic exposure manoeuvre on oropharyngeal leak pressure using SaCoVLM™ video laryngeal mask among patients undergoing general anesthesia

Chun-Ling Yan, Yi-Qi-Yuan Zhang, Ying Chen, Zong-Yang Qv, Ming-Zhang Zuo, Chun-Ling Yan, Yi-Qi-Yuan Zhang, Ying Chen, Zong-Yang Qv, Ming-Zhang Zuo

Abstract

To compare the potential influences of blind insertion and up-down optimized glottic exposure manoeuvre on the oropharyngeal leak pressure (OPLP) in using SaCoVLM™ video laryngeal mask (VLM) among patients undergoing general anesthesia. A randomized self-control study controlled was conducted to investigate the effect of two insertion techniques on OPLP. A total of 60 patients (male or female, 18-78 years, BMI 18.0-30.0 kg m-2 and ASA I-II) receiving selective surgery under general anesthesia were randomly recruited. After induction of anesthesia, the SaCoVLM™ was inserted by blind insertion manoeuvre. The glottic exposure grading(V1) of the SaCoVLM™ visual laryngeal mask and the OPLP(P1) were recorded. And the glottic exposure grading(V2) and OPLP(P2) of SaCoVLM™ were recorded again when the glottic exposure grading was optimal. The glottis exposure grading and OPLP were compared before and after different insertion manoeuver. The glottic exposure grading (V2) obtained by using up-down optimized glottic exposure manoeuvre was better than that obtained by using blind insertion manoeuvre (V1)(P < 0.001). The OPLP was significantly lower in the blind insertion manoeuvre (P1) than in the up-down optimized glottic exposure manoeuvre (P2) (32.4 ± 5.0 cmH2O vs. 36.3 ± 5.2 cmH2O, P < 0.001). In using SaCoVLM™, higher OPLP and better glottic exposure grading were achieved through up-down optimized glottic exposure manoeuvre, protecting the airway while real-time monitoring of conditions around the glottis, which significantly improves airway safety. Our results suggests that up-down optimized glottic exposure manoeuver may be a useful technique for SaCoVLM™ insertion.Trial registration: ChiCTR, ChiCTR2000028802. Registered 4 January 2020, http://www.chictr.org.cn/ChiCTR2000028802.

Keywords: Blind insertion manoeuvre; Glottic exposure grading; Oropharyngeal leak pressure; SaCoVLM™ video laryngeal mask (VLM); Up-down optimized glottic exposure manoeuvre.

Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
SaCoVLM™ disposable video laryngeal mask
Fig. 2
Fig. 2
SaCoVLM™ Glottic exposure grades. Grade 1: visualization of the lateral part of the right aryepiglottic fold and part of the laryngeal inlet, and the ventilation was good; Grade 2: visualization of the bilateral aryepiglottic fold and part of laryngeal inlet, and the ventilation was good; Grade 3: visualization of all laryngeal inlet and posterior glottis; Grade 4: visualization of the whole glottis

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