Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1016/j.bjane.2014.08.003
Brazilian Journal of Anesthesiology
Scientific Article

The association between thenar eminence and I-gel(tm) dimensions in paediatric patients

Associação entre as dimensões da eminência tênar e I-gel(tm) em pacientes pediátricos

Ozgun Cuvas Apan; Alparslan Apan

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Abstract

ABSTRACT OBJECTIVES: A practical anatomic landmark may be helpful to perform the appropriate size of the airway devices easily in paediatric patients. The aim of this study was to investigate the association between thenar eminence and I-gel dimensions in children. METHODS: After Institutional Ethics Committee approval, two hundred and seventy ASA Class I-II patients between 0 and 12 years old, who were scheduled for elective procedures under general anaesthesia not requiring tracheal intubation, were recruited to the study. The size of the I-gel selected was based on the patient's body weight according to the manufacturer's recommendation. After successful insertion of the I-gel, thenar eminence dimensions were determined. Long-axis (Th-l) was measured from junction point of the thumb to wrist curl and short-axis (Th-w) constitutes the largest portion of the thenar eminence from lateral end of the thumb to the first hand line. The manufacturer's dimensions of the I-gel which was inserted into the patients were compared with the measurements obtained from thenar eminence. RESULTS: The mean (SD) values for (Ig-w) and (Ig-l) were 2.98 cm (0.53) and 4.54 cm (0.82), and the mean (SD) values for (Th-w) and (Th-l) were 2.99 cm (0.60) and 3.88 cm (0.93), respectively. There was a statistically significant correlation between Th-w and Ig-w (r = 0.794,p < 0.001), and between Th-l and Ig-l (r = 0.820, p < 0.001). CONCLUSION: The dimensions of thenar eminence were fitted to that of the weight based size of I-gel and this anatomic landmark may be a practical tool to assess appropriate size for paediatric patients.

Keywords

Thenar eminence, I-gel(tm) airway device, Paediatric

Resumo

RESUMO OBJETIVOS: Uma referência anatômica prática pode ser útil para determinar o tamanho adequado dos dispositivos para vias aéreas em pacientes pediátricos. O objetivo deste estudo foi investigar a associação entre as dimensões da eminência tênar e do dispositivo I-gel em crianças. MÉTODOS: Após aprovação do Comitê de Ética Institucional, 270 pacientes com estado físico ASA I-II, entre 0-12 anos, programados para cirurgias eletivas sob anestesia geral, sem necessidade de intubação traqueal, foram recrutados para o estudo. A escolha do tamanho do I-gel foi baseada no peso corporal do paciente, de acordo com a recomendação do fabricante. Após a inserção bem-sucedida do I-gel, a dimensão da eminência tênar era determinada. O eixo longo (Th-l) foi medido do ponto de junção do polegar ao vinco do pulso e o eixo curto (Th-w) constitui a maior parte da eminência tênar da extremidade lateral do polegar à primeira linha da mão. As dimensões de fábrica do I-gel inserido no paciente foram comparadas com as dimensões obtidas a partir da eminência tênar. RESULTADOS: As médias (DP) dos valores para (Ig-w) e (Ig-l) foram 2,98 cm (0,53) e 4,54 cm (0,82) e as médias (DP) dos valores para (Th-w) e (TH l) foram 2,99 cm (0,60) e 3,88 cm (0,93), respectivamente. Houve uma correlação estatisticamente significativa entre Th-w e Ig-w (r = 0,794, p < 0,001) e entre Th-l e Ig-l (r = 0,820, p < 0,001). CONCLUSÃO: As dimensões da eminência tênar foram ajustadas àquelas do tamanho do I-gel baseado no peso e essa referência anatômica pode ser uma ferramenta prática para avaliar o tamanho apropriado em pacientes pediátricos.

Palavras-chave

Eminência tênar, Dispositivo de via aérea I-gel(tm), Pediátrico

References

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