Overview
This prospective observational study aims to compare ultrasonographic upper-airway measurements and age-related anatomical differences between young adults (18-40 years) and older adults (\>65 years), and to evaluate their effects on laryngeal mask airway (LMA) placement success and position accuracy. Preoperative airway ultrasonography measurements will be assessed, followed by evaluation of LMA placement, ventilation efficacy, insertion attempts, placement time, and complications. Ultrasonography will also be used to assess LMA position after placement, with confirmation by leak testing and fiberoptic evaluation. Preoperative and postoperative gastric volume will additionally be assessed.
Description
Laryngeal mask airway use is common in general anesthesia. Age-related anatomical and physiological changes of the upper airway may influence LMA placement in older adults. The study will prospectively evaluate patients undergoing procedures suitable for LMA placement at Düzce University Faculty of Medicine. Participants will be divided into young adults (18-40 years) and older adults (\>65 years). Demographic, anthropometric, clinical airway assessment and ultrasonographic airway measurements will be recorded. Following standardized induction, a ProSeal LMA will be placed by an anesthesia research resident with at least three years of experience. The number of insertion attempts and placement time will be recorded. LMA position will be assessed by ultrasonography and compared with leak testing and fiberoptic confirmation. Ventilation parameters, cuff pressure, LMA position changes, gastric volume and postoperative complications will also be recorded.
Eligibility
Inclusion Criteria:
- Patient or legally appropriate representative/relative accepts participation as applicable.
- Surgery suitable for LMA placement.
- Age 18-40 years or \>65 years.
Exclusion Criteria:
- Pregnancy
- Age \<18 years
- History of upper airway surgery
- Gastroesophageal reflux disease, ulcer, or gastrointestinal bleeding history
- Inadequate fasting duration
- Emergency surgery
- Requirement for nasogastric tube placement
- Unstable teeth
- Mouth opening \<3 cm
- Recent pulmonary infection
- Recent upper airway infection
- Pulmonary disease associated with increased airway pressures (cystic fibrosis, COPD, interstitial lung disease)
- Restricted cervical movement / inability to achieve required extension
- Ultrasound gel allergy
- Refusal to participate
