BJA Advance Access published online on December 10, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aei045
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1 Department of Anaesthesia and Intensive Care Therapy, Philipps University Marburg, 35033 Marburg, Germany
* To whom correspondence should be addressed. Background. One of the main concerns with the use of the standard laryngeal mask airway (SLMA) in small infants is that its low-pressure seal might be inadequate for positive pressure ventilation so that there is a risk of gas leakage into the stomach with the subsequent risk of regurgitation. The new ProSealTM LMA (PLMA) has been shown to form a more effective seal than the SLMA and to facilitate gastric tube placement in adults. The first paediatric size PLMA became available recently. Methods. Thirty anaesthetized, non-paralysed children aged 46 (19) months, weighing 16 (10-21) kg, were studied. The SLMA and PLMA were inserted in random order into each patient. Airway leak pressure and maximum tidal volume were measured. Ease of insertion, quality of initial airway and fibreoptic position were also determined. Gastric tube placement was assessed for the PLMA. Results. The airway leak pressure and maximum tidal volume were significantly higher for the PLMA (P=0.001). Ease of insertion and quality of initial airway were similar for both devices. Air entry into the stomach occurred more frequently with the SLMA (P=0.005). Gastric tube placement was possible in all patients. Conclusions. The size 2 PLMA offered some advantages over the same size of SLMA in this crossover investigation. The high reliability of gastric tube placement and the significantly increased airway leak pressure might have important implications for use of this device for positive pressure ventilation in infants.
Accepted September 14, 2004
Clinical Investigation
Size 2 ProSealTM laryngeal mask airway: a randomized, crossover investigation with the standard laryngeal mask airway in paediatric patients
1*
K. Goldmann, E-mail: kaigoldmann1{at}aol.com
Abstract Declaration of interest. K.G. has received an honorarium for lecturing at regional meetings from LMA Vertriebs-GmbH, the German distributor of the PLMA.
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