***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The conventional sequence when using supraglottic airway devices is insertion , cuff inflation and fixation . Our hypothesis was that a tighter fit of the cuff and tip could be achieved with a consequently lower incidence of air leak , better separation of gastrointestinal and respiratory tracts and less airway morbidity if the device were first affixed and the cuff then inflated . Methods Our clinical review board approved the study ( public registry number DRKS00003174 ) . An LMA Supreme ® was inserted into 184 patients undergoing lower limb arthroscopy in propofol-remifentanil anaesthesia  who were r and omly assigned to either the control ( inflation then fixation ; n = 92 ) or study group ( fixation then inflation ; n = 92 ) . The cuff was inflated to 60 cmH2O . The patients ’ lungs were ventilated in pressure-controlled mode with 5 cmH2O PEEP , Pmax to give 6 ml kg-1 tidal volume , and respiratory rate adjusted to end-tidal CO2 of 4.8 and 5.6 kPa . Correct cuff and tip position were determined by leak detection , capnometry trace , oropharyngeal leak pressure , suprasternal notch test , and lube-tube test . Bowl and cuff position and the presence of glottic narrowing were assessed by fiberscopic examination . Postoperative dysphagia , hoarseness and sore throat were assessed with a question naire . Ventilatory impairment was defined as a tidal volume < 6 ml kg-1 with Pmax at oropharyngeal leak pressure , glottic narrowing was defined as an angle between the vocal cords under 16 degrees . Results The incidence of incorrect device position ( 18 % vs. 21 % ) , failed ventilation ( 10 % vs. 9 % ) , leak pressure ( 24.8 vs. 25.2 cmH2O , p = 0.63 ) , failed lube-tube test ( 16.3 % vs. 17.6 % ) and glottic narrowing ( 19.3 % vs. 14.1 % , p = 0.35 ) was similar in both groups ( control vs. study , resp . ) . When glottic narrowing occurred , it was more frequently associated with ventilatory impairment in the control group ( 77 % vs. 39 % ; p = 0.04 ) . Airway morbidity was more common in the control group ( 33 % vs. 19 % ; p < 0.05 ) . Conclusions Altering the sequence of cuff inflation and device fixation does not affect device position , oropharyngeal leak pressures or separation of gastrointestinal and respiratory tracts . It reduces the incidence of glottic narrowing with impaired ventilation and also perioperative airway morbidity Background : The Glide Scope videolaryngoscope provides a suitable view for intubation , with less force required . Objectives : The present study was conducted , to compare postoperative sore throat and hoarseness after laryngoscopy and intubation , by Macintosh blade or Glide Scope video laryngoscope  in normal airway patients . Patients and Methods : Three hundred patients were r and omly allocated into two groups of 150 : Macintosh blade laryngoscope or Glide Scope video laryngoscope . The patients were evaluated for 48 hours for sore throat and hoarseness by an interview . Results : The incidence and severity of sore throat in the Glide Scope group , at 6 , 24 and 48 hours after the operation , were significantly lower than in the Macintosh laryngoscope group . In addition , the incidence of hoarseness in the Glide Scope group , at 6 and 24 hours after the operation , were significantly lower than in the Macintosh laryngoscope group . The incidence and severity of sore throat  in men , at 6 and 24 hours after the operation , were significantly lower than in the women . Conclusions : The incidence and severity of sore throat and hoarseness after tracheal intubation by Glide Scope were lower than in the Macintosh laryngoscope . The incidence and severity of sore throat were increased by intubation and longer operation times OBJECTIVE To compare the severity of throat discomfort in terms of sore throat , dysphagia , and dysphonia caused by LMA-ProSeal ( PLMA ) and Profile Soft-Seal Cuff ( PSSC ) in early ( 2 hour ) and late ( 24 hour ) postoperative period after ambulatory gynecologic laparoscopy .  DESIGN R and omized double-blind controlled trial . MATERIAL AND METHOD One hundred and thirty eight patients undergoing ambulatory gynecologic laparoscopy in Chulalongkorn Memorial Hospital were r and omly allocated into two groups . One group was intubated with Profile-Soft-Seal Cuff ( PSSC ) , while the other with ProSeal LMA ( PLMA ) .  Four-leveled score of sore throat , dysphagia , dysphonia , nausea , or vomiting symptoms at 2 and 24 hours and 5-leveled satisfaction score to both techniques at 24 hours postoperatively were evaluated . RESULTS The patients in the PLMA group had less severe symptoms of sore throat ( p = 0.016 ) and dysphonia ( p = 0.003 ) than those in the PSSC group at 2 hour . No difference was detected for dysphagia , nausea , vomiting , and satisfaction scores at 24 hour postoperatively . CONCLUSION PLMA caused less sore throat and dysphonia in the early postoperative period than PSSC did PLMA can be used as an alternative airway device for anesthesia in ambulatory gynecologic laparoscopy Background Postoperative sore throat and hoarseness are common minor complications following airway manipulation . This study was primarily done to determine gender differences in the incidence of these symptoms and the location of POST after laryngeal mask airway ( LMA ) and endotracheal tube ( ETT ) . Methods A total of 112 men and 185 women were included during a four month period . All patients were evaluated postoperatively and after 24 hours about the occurrence of sore throat , its location and hoarseness . If the patients had any symptom , they were followed-up at 48 , 72 and 96 hours until the symptoms resolved . Results There was no significant gender difference in postoperative sore throat ( POST ) and postoperative hoarseness ( PH ) when analyzing both airway devices together . The incidence of sore throat and hoarseness were higher postoperatively after an ETT than an LMA ( 32 % vs. 19 % , p = 0.012 ) and 57 % vs. 33 % ( p < 0.001 ) respectively . Significantly more women than men had POST after an LMA ( 26 % vs. 6 % , p = 0.004 ) . No significant gender difference was found in either POST or PH after an ETT or in the incidence of PH after an LMA . More patients located their pain below the larynx after an ETT vs. an LMA ( 24 % vs. 4 % ) . Pain above the larynx was more common after an LMA than an ETT ( 52 % vs. 37 % ) . Conclusions In a clinical setting where women are intubated with a smaller size ETT than men , there were no significant differences in POST or PH between genders . Additionally , more women than men have POST when an LMA is used . Awareness of POST and PH may help streamline patients in whom the best airway device could be used during anesthesia and surgery Postoperative pharyngolaryngeal complications ( PPLC ) occur during anaesthesia due to increased cuff pressure following the insertion of laryngeal mask airways . The use of a pressure regulator to prevent PPLC was evaluated in a prospect i ve , r and omized study . Sixty patients scheduled to receive general anaesthesia were r and omly assigned to two equal groups of 30 , either with or without the regulator .  The ‘ just seal ’ cuff pressure ( JSCP ) , cuff pressure at 5-min intervals during anaesthesia , incidence of pharyngeal sore throat ( PST ) , dysphagia , dysphonia and other complications were evaluated at 1 and 24 h postoperatively . The combined mean ± SD JSCP of both groups was 20.3 ± 3.2 mmHg . In the group with the regulator , cuff pressure was maintained at a constant level during anaesthesia . This study demonstrated that the regulator is a simple , functional device that can reduce the incidence of PST significantly at 1 h postoperatively , following general anaesthesia Purpose To compare the efficacy of the ProSeal LMA ™ and SLIPA ™ supralaryngeal airways ( SLA ) with the st and ard tracheal tube ( TT ) in 150 consecutive day-case laparoscopic gynecological surgery procedures requiring general anesthesia . Methods One hundred and fifty patients were r and omized into three groups . An identical general anesthesia technique was used in all patients apart from the addition of muscle relaxants and reversal drugs in the TT group . Patients were excluded if there were risk factors for gastroesophageal reflux .  Ease of use , quality of seal , ventilation , systolic pressure , response to intubation , side effects and operating room time were assessed . Results Both ProSeal LMA ™ and SLIPA ™ were easy to insert ( 100 % success ) and ventilate with respective mean ( st and ard deviation ) maximum sealing pressures of 31 ( 4.6 ) and 30 ( 5.2 ) cmH2O ( P = 0.4 ) with no muscle relaxants . The seal quality in both ProSeal LMA ™ and SLIPA ™ permitted the use of low flows , 485 ( 291 ) and 539 ( 344 ) mL·min-1 ( P = 0.2 ) respectively , although in the TT group significantly lower flows [ 377 ( 124 ) mL·min-1 ] , ( P < 0.01 ) were achieved . Systolic pressure in the SLA groups was more stable in response to insertion than in the TT . With ProSeal ™ there was a lower incidence of sore throats than with TT ( 30 % vs 57 % ) , ( P < 0.05 ) , but there was a lesser difference as compared with SLIPA ™ ( 30 % vs 49 % ) , ( P > 0.05 ) . With both SLAs , there was a significant reduction in operating room time ( > three minutes ) , ( P < 0.001 ) . Conclusions These results suggest that the ProSeal LMA ™ ( reusable ) and SLIPA ™ ( single-use ) SLAs were easy to use without requiring muscle relaxants , and reduce operating room time compared to the TT technique in day case laparoscopies . RésuméObjectifComparer ľefficacité des canules supralaryngées ( CSL ) ProSeal LMA ™ et SLIPA ™ avec celle du tube endotrachéal ( TET ) régulier dans 150 interventions gynécologiques laparoscopiques consécutives nécessitant une anesthésie générale . MéthodeNous avons réparti 150 patientes au hasard en trois groupes . La même technique ďanesthésie générale a été appliquée chez toutes , sauf ľaddition de myorelaxants et de contre-myorelaxants avec le TET . Certaines ont été exclues s’il y avait des risques de reflux gastro-œsophagien . La facilité ďutilisation , ľétanchéité , la ventilation , la tension artérielle systolique , la réaction à ľintubation , les effets secondaires et le temps en salle ďopération ont été évalués . RésultatsĽinsertion des ProSeal LMA ™ et SLIPA ™ ( 100 % de succès ) et la ventilation ont été faciles avec une moyenne respective ( écart type ) maximale de pression ďétanchéité de 31 ( 4,6 ) et 30 ( 5,2 ) cmH2O ( P = 0,4 ) sans myorelaxants . La bonne étanchéité des ProSeal LMA ™ et SLIPA ™ a permis ďutiliser de faibles débits , respectivement de 485 ( 291 ) et 539 ( 344 ) mL·min-1 ( P = 0,2 ) , et significativement plus bas [ 377 ( 124 ) mL·min-1 ] , ( P < 0,01 ) avec le TET . La tension systolique chez les patients des groupes CSL , comparés au groupe TET , a été plus stable en réaction à ľinsertion de la canule . Avec le ProSeal ™ , comparé au TET , il y a eu une incidence plus faible de mal de gorge ( 30 % vs 57 % ) , ( P < 0,05 ) , et une plus petite différence avec le SLIPA ™ ( 30 % vs 49 % ) , ( P > 0,05 ) . Avec les CSL , le temps en salle ďopération a été significativement réduit ( > trois minutes ) , ( P < 0,001 ) . Conclusion Ces résultats montrent que , pour des laparoscopies , les CSL ProSeal LMA ™ ( réutilisable ) et SLIPA ™ ( jetable ) ont été faciles à utiliser sans nécessiter de myorelaxants et qu’ils réduisent le temps de salle ďopération comparativement au TET Background and objective The I-gel is a new single-use supraglottic airway device without an inflatable cuff . 
    Output:
    
In adults undergoing tracheal intubation  , female sex , younger age , pre-existing lung disease , prolonged duration of anaesthesia and the presence of a blood-stained tracheal tube on extubation are associated with the greatest risk .
Tracheal intubation without neuromuscular blockade , use of double-lumen tubes , as well as high tracheal tube cuff pressures may also increase the risk of postoperative sore throat .
The expertise of the anaesthetist performing tracheal intubation appears to have no influence on the incidence in adults , although it may in children .
In adults , the i-gel ( ™ ) supraglottic airway device results in a lower incidence of postoperative sore throat .
Cuffed supraglottic airway devices should be inflated sufficiently to obtain an adequate seal and intracuff pressure should be monitored .
Children with respiratory tract disease are at increased risk .
The use of supraglottic airway devices , oral , rather than nasal , tracheal intubation and cuffed , rather than uncuffed , tracheal tubes have benefit in reducing the incidence of postoperative sore throat in children .
Limiting both tracheal tube and supraglottic airway device cuff pressure may also reduce the incidence