British Journal of Anaesthesia, Vol 82, Issue 5 703-707, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
J. Brimacombe and C. Keller
We have compared ease of insertion, oropharyngeal leak pressure, directly
measured pharyngeal mucosal pressure and anatomical position (assessed
fibreoptically) for the size 4 and size 5 laryngeal mask airway (LMA) in 20
male and 20 female patients. Microchip pressure sensors were attached to
the LMA at locations corresponding to the piriform fossa, hypopharynx, base
of the tongue, lateral and posterior pharynx, and the oropharynx.
Oropharyngeal leak pressure, mucosal pressure and fibreoptic position were
recorded during inflation of the cuff from 0 to 30 ml in 10-ml increments.
In males, oropharyngeal leak pressure over the inflation range was higher
for size 5 (21 vs 17 cm H2O; P = 0.01); mucosal pressure over the inflation
range was higher in the posterior pharynx for size 4 (7 vs 2 cm H2O; P =
0.007), and higher in the piriform fossa (8 vs 5 cm H2O; P = 0.003) and
hypopharynx (9 vs 5 cm H2O; P = 0.003) for size 5. In females,
oropharyngeal leak pressure over the inflation range was the same (21 vs 21
cm H2O), but mucosal pressure over the inflation range was higher in the
piriform fossa (21 vs 8 cm H2O; P = 0.003) and posterior pharynx (4 vs 2 cm
H2O; P = 0.004) for size 4, and higher in the lateral pharynx (5 vs 1 cm
H2O; P = 0.01) and oropharynx (11 vs 5 cm H2O; P = 0.009) for size 5. The
distribution of mucosal pressure was different for size 4 between males and
females, but not for size 5. For both males and females, fibreoptic
position was similar. We conclude that the size 5 LMA is optimal in males,
but either size is suitable for females. The shape of the pharynx may be
different between males and females.
CLINICAL INVESTIGATIONS
Laryngeal mask airway size selection in males and females: ease of insertion, oropharyngeal leak pressure, pharyngeal mucosal pressures and anatomical position
University of Queensland, Department of Anaesthesia and Intensive Care, Cairns Base Hospital, Cairns 4870, Australia; Cairns Base Hospital, Cairns 4870, Australia; Department of Anaesthesia and Intensive Care Medicine, Leopold-Franzens University, A-6020 Innsbruck, Austria
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