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A comparison of the proseal laryngeal mask airway™, the laryngeal tube S® and the oesophageal–tracheal combitube™ during routine surgical procedures

Published online by Cambridge University Press:  11 May 2005

B. Bein ,
S. Carstensen ,
M. Gleim ,
L. Claus ,
P. H. Tonner ,
M. Steinfath ,
J. Scholz  and
V. Dörges
B. Bein
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
S. Carstensen
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
M. Gleim
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
L. Claus
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
P. H. Tonner
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
M. Steinfath
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
J. Scholz
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
V. Dörges
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Campus Kiel, Kiel, Germany
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Extract

Summary

Background and objective: This study was performed to compare three supraglottic airway devices: the ProSeal laryngeal mask airway (PLMA), the laryngeal tube S (LTS) and the oesophageal–tracheal combitube (OTC) during routine surgical procedures.

Methods: Ninety American Society of Anesthesiologists (ASA) I–III patients scheduled for routine minor obstetric surgery were randomly allocated to the PLMA (n = 30), the LTS (n = 30) or the OTC (n = 30) group, respectively. The overall success rate, insertion time, cuff pressures and resulting airway leak pressures were determined as well as a subjective assessment of handling and the incidence of sore throat, dysphagia and hoarseness were performed.

Results: Insertion time until the first adequate ventilation was significantly (P < 0.0001) shorter in the PLMA (median 29 s; 25–75th percentile 25–48 s; range 10–161 s; success rate 100%) and in the LTS group (38 s; 30–44 s; 13–180 s; 100%) compared to the OTC group (75 s; 48–98 s; 35–180 s; 90%). In vivo cuff pressures and airway leak pressures increased with the inflating cuff volume in all devices and were highest in the OTC group. Postoperatively, patients in the PLMA and the LTS group complained significantly less about sore throat (P < 0.001 and 0.05) and dysphagia (P < 0.001 and 0.02) compared to the OTC group, while there was no difference regarding the incidence of hoarseness. Subjective assessment of handling was comparable with the PLMA and the LTS, but inferior with the OTC.

Conclusions: In conclusion, both PLMA and LTS proved to be suitable for routine surgical procedures and proved to be superior to the OTC which cannot be recommended for routine use.

Keywords

LARYNGEAL MASKS, complicationsANAESTHESIA, airway, laryngeal tube, complicationsINTERMITTENT POSITIVE PRESSURE VENTILATION
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 5 , May 2005 , pp. 341 - 346
Copyright
© 2005 European Society of Anaesthesiology

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References

Dorges V, Wenzel V, Neubert E, Schmucker P. Emergency airway management by intensive care unit nurses with the intubating laryngeal mask airway and the laryngeal tube. Crit Care 2000; 4: 369–376.Google Scholar
Dorges V, Wenzel V, Schumann T, et al. Intubating laryngeal mask airway, laryngeal tube, 1100 mL self-inflating bag-alternatives for basic life support? Resuscitation 2001; 51: 185–191.Google Scholar
Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2003; 98: 1269–1277.
Brimacombe J, Keller C, Fullekrug B, et al. A multicenter study comparing the ProSeal and Classic laryngeal mask airway in anesthetized, nonparalyzed patients. Anesthesiology 2002; 96: 289–295.Google Scholar
Dorges V, Ocker H, Wenzel V, et al. The laryngeal tube S: a modified simple airway device. Anesth Analg 2003; 96: 618–621.Google Scholar
Stringer KR, Bajenov S, Yentis SM. Training in airway management. Anaesthesia 2002; 57: 967–983.Google Scholar
Keller C, Brimacombe J, Boehler M, et al. The influence of cuff volume and anatomic location on pharyngeal, esophageal, and tracheal mucosal pressures with the esophageal tracheal combitube. Anesthesiology 2002; 96: 1074–1077.Google Scholar
Gaitini LA, Vaida SJ, Mostafa S, et al. The combitube in elective surgery: a report of 200 cases. Anesthesiology 2001; 94: 79–82.Google Scholar
Mandal NG. Combitube and similar devices should undergo long-term safety evaluation before their routine use in clinical practice. Anesthesiology 2001; 95: 1041–1042.Google Scholar
Keller C, Brimacombe JR, Keller K, Morris R. Comparison of four methods for assessing airway sealing pressure with the laryngeal mask airway in adult patients. Br J Anaesth 1999; 82: 286–287.Google Scholar
Miller DM, Light D. Storage capacities of the laryngeal mask and laryngeal tube compared and their relevance to aspiration risk during positive pressure ventilation. Anesth Analg 2003; 96: 1821–1822.Google Scholar
Keller C, Brimacombe J, Kleinsasser A, Loeckinger A. Does the ProSeal laryngeal mask airway prevent aspiration of regurgitated fluid? Anesth Analg 2000; 91: 1017–1020.Google Scholar
Brimacombe J, Keller C. Aspiration of gastric contents during use of a ProSeal laryngeal mask airway secondary to unidentified foldover malposition. Anesth Analg 2003; 97: 1192–1194.Google Scholar
O'Connor Jr CJ, Davies SR, Stix MS, Dolan RW. Gastric distention in a spontaneously ventilating patient with a ProSeal laryngeal mask airway. Anesth Analg 2002; 94: 1656–1658.Google Scholar
Stix MS, Borromeo CJ, O'Connor Jr CJ. Esophageal insufflation with normal fiberoptic positioning of the ProSeal laryngeal mask airway. Anesth Analg 2002; 94: 1036–1039.Google Scholar
Matioc AA, Arndt G. The laryngeal tube and pharyngeal mucosal pressure. Can J Anaesth 2003; 50: 525–526.Google Scholar
Oczenski W, Krenn H, Dahaba AA, et al. Complications following the use of the combitube, tracheal tube and laryngeal mask airway. Anaesthesia 1999; 54: 1161–1165.Google Scholar
Becker Jr KE, Carrithers J. Practical methods of cost containment in anesthesia and surgery. J Clin Anesth 1994; 6: 388–399.Google Scholar
Brimacombe J, Keller C, Roth W, Loeckinger A. Large cuff volumes impede posterior pharyngeal mucosal perfusion with the laryngeal tube airway. Can J Anaesth 2002; 49: 1084–1087.Google Scholar
Keller C, Brimacombe J. Mucosal pressure and oropharyngeal leak pressure with the ProSeal versus laryngeal mask airway in anaesthetized paralysed patients. Br J Anaesth 2000; 85: 262–266.Google Scholar
Brimacombe J, Holyoake L, Keller C, et al. Emergence characteristics and postoperative laryngopharyngeal morbidity with the laryngeal mask airway: a comparison of high versus low initial cuff volume. Anaesthesia 2000; 55: 338–343.Google Scholar