Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-19T00:53:29.804Z Has data issue: false hasContentIssue false
  • English
  • Français

Stability of the LMA-ProSeal® and standard laryngeal mask airway in different head and neck positions: a randomized crossover study

Published online by Cambridge University Press:  02 June 2005

J. Brimacombe  and
C. Keller
J. Brimacombe
Affiliation:
University of Queensland and James Cook University, Department of Anaesthesia and Intensive Care, Cairns Base Hospital, Australia
C. Keller
Affiliation:
Leopold-Franzens University, Department of Anaesthesia and Intensive Care Medicine, Innsbruck, Austria
Get access

Extract

Summary

Background and objective: The LMA-ProSeal® laryngeal mask airway is a new laryngeal mask airway with a modified cuff and drainage tube. We compared oropharyngeal leak pressure, intracuff pressure and anatomical position (assessed fibreoptically) for the Size 5 LMA-ProSeal® laryngeal mask airway and the classic laryngeal mask airway in different head–neck positions and using different intracuff inflation volumes.

Methods: Thirty paralysed anaesthetized adult male patients were studied. The LMA-ProSeal® laryngeal mask airway and the classic laryngeal mask airway were inserted into each patient in random order. The oropharyngeal leak pressure, intracuff pressure, and anatomical position of the airway tube and drainage tube (LMA-ProSeal® laryngeal mask airway only) were documented in four head and neck positions (neutral first, then flexion, extension and rotation in random order), and at 0–40 mL cuff volumes in the neutral position in 10 mL increments.

Results: Compared with the neutral position, the oropharyngeal leak pressure for both the LMA-ProSeal® laryngeal mask airway and the classic laryngeal mask airway was higher in flexion and rotation (all P ≤ 0.02), but lower in extension (all P ≤ 0.01). Changes in head–neck position did not alter the anatomical position of the airway tube or the drainage tube. The oropharyngeal leak pressure was always higher for the LMA-ProSeal® laryngeal mask airway (all P ≤ 0.005) and anatomical position better for the classic laryngeal mask airway (all P ≤ 0.04).

Conclusions: The anatomical position of the LMA-ProSeal® and the classic laryngeal mask airway is stable in different head–neck positions, but head–neck flexion and rotation are associated with an increase, and head–neck extension a decrease, in oropharyngeal leak pressure and intracuff pressure. The Size 5 LMA-ProSeal® laryngeal mask airway is capable of forming a more effective seal than the Size 5 classic laryngeal mask airway in males.

Keywords

EQUIPMENT AND SUPPLIESINTUBATION, INTRATRACHEAL, laryngeal masks
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 1 , January 2003 , pp. 65 - 69
Copyright
© 2003 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brain AIJ, Verghese C, Strube PJ. The LMA ‘ProSeal’ – a laryngeal mask with an oesophageal vent. Br J Anaesth 2000; 84: 650–654.Google Scholar
Keller C, Brimacombe J. The influence of head and neck position on oropharyngeal leak pressure and cuff position with the flexible and the standard laryngeal mask airway. Anesth Analg 1999; 88: 913–916.Google Scholar
Buckham M, Brooker M, Brimacombe J, Keller C. A comparison of the reinforced and standard laryngeal mask airway: ease of insertion and the influence of head and neck position on oropharyngeal leak pressure and intracuff pressure. Anaesth Intens Care 1999; 27: 628–631.Google Scholar
Berry AM, Brimacombe J, McManus KF, Goldblatt M. An evaluation of the factors influencing selection of the optimal size of laryngeal mask airway in normal adults. Anaesthesia 1998; 53: 565–570.Google Scholar
Keller C, Brimacombe J, Keller K, Morris R. A 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
Brimacombe J, Berry A. A proposed fiber-optic scoring system to standardize the assessment of laryngeal mask airway position. Anesth Analg 1993; 76: 457.Google Scholar
Miller AC, Bickler P. The laryngeal mask airway. An unusual complication. Anaesthesia 1991; 46: 659–660.Google Scholar