Superior sealing effect of a three-dimensional printed modified supraglottic airway compared with the i-gel in a three-dimensional printed airway model
- 116 Downloads
The aim of this study was to compare the force exerted by a three-dimensional (3D) printed modified supraglottic airway (mSGA) vs. that exerted by the i-gel on a 3D printed airway model.
After a preliminary experiment in Thiel embalmed cadavers, we created a 3D printed mSGA and five 3D printed airway models based on computed tomography data from five female Japanese patients. We compared the force exerted by the i-gel and mSGA on the larynx of the 3D printed airway models. In addition, tidal volumes with insertion of the airway devices into the 3D printed airway model and administration of different levels of pressure-controlled ventilation (PCV) were compared.
The values below indicate mean values ± SD (p value, 95% confidence interval) for the mSGA and i-gel, respectively. The forces exerted by the cuff parts were as follows: ventral: 12.5 ± 5.4 vs. 20.7 ± 3.7 N (p = 0.0001, − 10.0 to − 6.5), proximal: 1.9 ± 1.4 vs. 1.7 ± 1.3 N (p = 0.322, − 0.26 to 0.74), and dorsal parts: 6.9 ± 2.2 vs. 12.5 ± 4.8 N (p = 0.0001, − 7.9 to − 3.4), respectively. We also found significantly higher tidal volumes with the mSGA under PCV of 10, 15, and 20 cmH2O.
The method of creating the mSGA that we proposed in this study can be applied to development of novel SGAs that is anatomically more suitable for pharyngolaryngeal structure.
KeywordsAirway management Laryngeal masks Three-dimensional Printing Pressure
We thank Prof. Mineko Fujimiya and the staff of the Department of Anatomy, Sapporo Medical University, School of Medicine for their management of the Thiel embalmed cadavers and for their cooperation in our preliminary cadaver experiments. This work was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant number 16K20107.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
- 3.Apfelbaum JL, Hagberg CA, Caplan RA, Blitt CD, Connis RT, Nickinovich DG, Hagberg CA, Caplan RA, Benumof JL, Berry FA, Blitt CD, Bode RH, Cheney FW, Connis RT, Guidry OF, Nickinovich DG, Ovassapian A, American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2013;118(2):251–70.CrossRefGoogle Scholar
- 5.Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, O’Sullivan EP, Woodall NM, Ahmad I, Difficult Airway Society intubation guidelines working group. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015;115(6):827–48.CrossRefGoogle Scholar
- 7.Berlac P, Hyldmo PK, Kongstad P, Kurola J, Nakstad AR, Sandberg M, Scandinavian Society for Anesthesiology and Intensive Care Medicine. Pre-hospital airway management: guidelines from a task force from the Scandinavian Society for Anaesthesiology and Intensive Care Medicine. Acta Anaesthesiol Scand. 2008;52(7):897–907.CrossRefGoogle Scholar
- 11.Kimijima T, Edanaga M, Yamakage M. Laryngeal mucosal pressure exerted by i-gel™: an experimental study in Japanese human cadavers. Anesthesiology A1132. 2016;67:407–10Google Scholar
- 12.i-gel. User Poster—adult sizes. http://www.intersurgical.co.uk/products/airway-management/i-gel-supraglottic-airway#downloads.