BJA Advance Access originally published online on October 6, 2005
British Journal of Anaesthesia 2005 95(6):827-830; doi:10.1093/bja/aei234
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RESPIRATION AND THE AIRWAY |
A randomized non-crossover study comparing the ProSealTM and ClassicTM laryngeal mask airway in anaesthetized children
1 Department of Anaesthesia and Reanimation, Maranon University Hospital, Madrid, Spain. 2 James Cook University, Department of Anaesthesia and Intensive Care, Cairns Base Hospital, Cairns, Australia. 3 Dental School, Department of Pharmacology School of Medicine, University Complutense, Madrid, Spain
* Corresponding author. E-mail: jbrimaco{at}bigpond.net.au
Background. We tested the hypothesis that ease of insertion, oropharyngeal leak pressure, fibreoptic position, gastric insufflation, and the frequency of mucosal trauma differ between the ProSeal laryngeal mask airway (PLMA) and the classic laryngeal mask airway (cLMA) in anaesthetized children. For the PLMA, we also assessed the ease of gastric tube placement via the PLMA drain tube and measure residual gastric volume.
Methods. 240 consecutive ASA I–III children aged 1–16 yr were randomized for airway management with the ProSeal or cLMA.
Results. The time taken to provide an effective airway, the number of insertion attempts, fibreoptic position of the airway tube and frequency of mucosal trauma were similar, but oropharyngeal leak pressure was higher (33 vs 26 cm H2O, P<0.0001) and gastric insufflation less common (0 vs 6%, P<0.01) for the PLMA. Gastric tube insertion was successful at the first attempt in 106 of 120, and at the second attempt in 14 of 120. The mean (SD; range) value for residual gastric volume was 2.2 (5.9; 0–30) ml. There were no differences in performance among sizes for the PLMA and the cLMA.
Conclusions. We conclude that ease of insertion, fibreoptic position, and frequency of mucosal trauma are similar for the PLMA and cLMA in children, but oropharyngeal leak pressure is higher and gastric insufflation less common for the PLMA. Gastric tube insertion has a high success rate, provided the PLMA is correctly positioned.
Declaration of interest. Dr Brimacombe has worked as a consultant for the Laryngeal Mask Company, who manufacture the ProSealTM laryngeal mask airway.
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