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The incidence of gastroesophageal reflux and tracheal aspiration detected with pH electrodes is similar with the Laryngeal Mask Airway® and Esophageal Tracheal Combitube® — a pilot study

  • Carin A. Hagberg
  • Tigran N. Vartazarian
  • Jacques E. Chelly
  • Andranik Ovassapian
Cardiothoracic Anesthesia, Respiration and Airway

Abstract

Purpose

Aspiration as a result of gastroesophageal reflux (GER) and regurgitation remains a serious potential problem in anesthetized patients. The incidence of GER with either the Esophageal Tracheal Combitube™ (ETC) or the laryngeal mask airway (LMA) was investigated using tracheal and esophageal pH electrodes.

Methods

Following approval by the Institutional Review Board and written informed consent, 57 patients of ASA physical status I to III were randomly assigned to receive either an LMA (Group I,n = 28) or an ETC (Group II,n = 29) during general anesthesia. All patients were paralyzed and received positive pressure ventilation. Two monocrystalline antimony catheters were used for pH monitoring: one unipolar catheter with a single pH sensor for tracheal pH measurements and one bipolar catheter with proximal and distal sensors for pharyngeal and esophageal pH measurements, respectively.

Results

One episode of GER occurred in a patient in Group II, yet there were no pH changes reflected in the oropharyngeal or tracheal regions. There were 3/25 (12%) patients in Group I vs 1/25 (4%) patients in Group II that met the pH criterion for aspiration (pH below 4.0 that lasted at least 15 sec), yet no patient developed any clinical signs of aspiration. In all patients, hemodynamic and respiratory variables remained stable throughout the period of measurement (data not included).

Conclusion

In this pilot study, the ETC appears comparable to the LMA regarding the incidence of GER and tracheal acid aspiration.

Keywords

Laryngeal Mask Airway Airway Device ProSeal Laryngeal Mask Airway Tracheal Aspiration Rigid Laryngoscope 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

L’incidence de reflux gastro-œsophagien et d’aspiration trachéale détectés au moyen d’électrodes à pH est similaire avec l’usage du Laryngeal Mask Airway® ou du Esophageal Tracheal Combitube® — une étude pilote

Résumé

Objectif

Laspiration résultant du reflux gastro-œsophagien (RGO) et la régurgitation demeurent un problème sérieux potentiel chez les patients anesthésiés. L’incidence de RGO notée avec l’utilisation du Esophageal Tracheal Combitube™ (ETC) ou avec le masque laryngé (ML) a été étudiée au moyen d’électrodes à pH placées dans la trachée et l’œsophage.

Méthode

Après avoir obtenu l’accord du Comité d’examen de l’hôpital et le consentement éclairé des sujets de l’étude, nous avons réparti en deux groupes de façon aléatoire 51 patients d’état physique ASA I à III qui ont reçu un ML (Groupe I, n = 28) ou un ETC (Groupe II, n = 29) pendant l’anesthésie générale. Tous les patients ont été paralysés et ont eu une ventilation à pression positive. Deux sondes en antimoine monocristallin ont été utilisées pour l’enregistrement du pH: une sonde unipolaire avec un seul capteur de pH pour les mesures tracheales et une bipolaire munie de capteurs proximal et distal pour les mesures pharyngienne et œsophagienne, respectivement.

Résultats

Il y a eu un épisode de RGO chez un patient du Groupe II, mais aucune modification du pH n’a été notée dans l’oropharynx ou la trachée. Aussi, 3/25 (12%) patients du Groupe I vs 1/25 (4 %) du Groupe II répondaient aux critères du pH d’aspiration (pH sous 4,0 pendant au moins 15 s), mais aucun signe clinique d’aspiration ne s’est développé. Les variables hémodynamiques et respiratoires sont demeurées stables chez tous les patients tout au long de la période de mesure (données non inclues).

Conclusion

LETC est comparable au ML quant à l’incidence de RGO et d’aspiration acide trachéale.

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Copyright information

© Canadian Anesthesiologists 2004

Authors and Affiliations

  • Carin A. Hagberg
    • 1
  • Tigran N. Vartazarian
    • 1
  • Jacques E. Chelly
    • 2
  • Andranik Ovassapian
    • 3
  1. 1.Department of AnesthesiologyThe University of Texas-Houston Medical SchoolHoustonUSA
  2. 2.Department of AnesthesiologyUniversity of Pittsburgh-School of MedicinePittsburgh
  3. 3.Department of AnesthesiologyUniversity of ChicagoChicagoUSA

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