A randomized non-crossover study comparing the ProSeal™ and Classic™ laryngeal mask airway in anaesthetized children

Lopez-Gil, M.; Brimacombe, J.; García, Gustavo

doi:10.1093/bja/aei234

Cited by 63 publications

(78 citation statements)

References 15 publications

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“…In these studies, neuromuscular blockade was not used and, although the pressure was not visible to the observer, the observer was not blinded to which airway device was used. Shimbori et al 18 performed a randomized, non-blinded study in 19 showed a difference in leak pressure between groups (PLMA 33 cm H 2 O; CLMA 26 cm H 2 O), as well as a higher incidence of gastric insufflation with the CLMA, with no difference in fibreoptic view. These mean leak pressures far exceed those observed in the studies previously described [15][16][17][18] as well as the current investigation.…”

Section: Discussionmentioning

confidence: 99%

Comparison of laryngeal mask airway (LMA)-Proseal™ and the LMA-Classic™ in ventilated children receiving neuromuscular blockade

Lardner

Cox

Ewen

et al. 2008

Can J Anesth/J Can Anesth

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CAN J ANESTH 55: 1 www.cja-jca.org Januar y, 2008Purpose: To determine whether a functional difference exists between the size 2 laryngeal mask airway (LMA)-Classic™ (CLMA) and LMA-Proseal™ (PLMA) in anesthetized children who have received neuromuscular blockade. Airway leak during intermittent positive pressure ventilation (IPPV) and adequacy of fibreoptic laryngeal view were the primary study outcomes. Methods:A randomized, controlled, single-blinded study of 51 ASA I or II children weighing 10-20 kg was undertaken. The anesthetic technique was standardized. Following insertion of the LMA and cuff inflation to 60 cm H 2 O, we measured oropharyngeal leak pressure and gastric insufflation and leak fraction during IPPV, and evaluated the adequacy of fibreoptic view.Results: Oropharyngeal leak pressure measured by neck auscultation was higher for the PLMA compared to the CLMA (23.7 vs 16.5 cm H 2 O, P = 0.009) but, when measured by the inspiratory hold maneuver was not significantly different (24.8 vs 20.3 cm H 2 O, respectively, P = 0.217). Leak fraction values were similar for the CLMA and the PLMA (21.2%. vs 13.3%, respectively, P = 0.473). A satisfactory view of the larynx was obtained more frequently in the PLMA group (21/25 vs 10/25, P = 0.003). Gastric insufflation during leak determination was more common with the CLMA (12/26 vs 2/25 CLMA vs PLMA, respectively, P = 0.006). Conclusion:In children undergoing IPPV with neuromuscular blockade, the size 2 PLMA is associated with a higher leak pressure by auscultation and less gastric insufflation compared to the CLMA. Leak pressures assessed by manometric stability are similar with these two devices. The improved fibreoptic view of the larynx through the PLMA may be advantageous for bronchoscopy. CLMA (23,7 vs 16,5 cm H 2 O, P = 0,009) ; toutefois, lorsque celle-ci a été mesurée par manoeuvre de retenue respiratoire, il n'y a pas eu de différence significative (24,8 vs 20,3 cm H 2 O, respectivement, P = 0,217). Les valeurs de fraction de fuite étaient semblables avec le CLMA et le PLMA (21,2 % vs 13,3 %, respectivement, P = 0,473). Une vision satisfaisante du larynx a été plus fréquemment obtenue dans le groupe PLMA (21/25 vs 10/25, P = 0,003). L'insufflation gastrique pendant la détermination de la fuite a été plus fréquemment observée dans le groupe CLMA (12/26 vs 2/25 CLMA vs PLMA, respectivement, P = 0,006).

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Section: Discussionmentioning

confidence: 99%

Comparison of laryngeal mask airway (LMA)-Proseal™ and the LMA-Classic™ in ventilated children receiving neuromuscular blockade

Lardner

Cox

Ewen

et al. 2008

Can J Anesth/J Can Anesth

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“…Sufficient ventilation was judged clinically by the presence of symmetric chest movements, stable oxygen saturation, stable square wave capnography trace with no audible oropharyngeal leak, and a tidal volume of at least 6 ml/kg body weight. 17,20 Minor airway interventions were recorded.…”

Section: Measurementsmentioning

confidence: 99%

Performance of the Pediatric-sized i-gel Compared with the Ambu AuraOnce Laryngeal Mask in Anesthetized and Ventilated Children

Theiler

Kleine‐Brueggeney

Luepold³

et al. 2011

Anesthesiology

119

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Background: This prospective, randomized, controlled trial compares the performance of the pediatric i-gel (Intersurgical Ltd., Wokingham, United Kingdom) with the Ambu AuraOnce laryngeal mask (Ambu A/S, Ballerup, Denmark) in anesthetized and ventilated children. Methods: With ethics committee approval and written informed consent, the authors included 208 children, aged 0 -17 yr, scheduled for elective day-surgery under general anesthesia. The primary outcome variable was oropharyngeal

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“…These devices all incorporate a drain tube to separate the respiratory and gastrointestinal tracts and minimise the risk of aspiration. They also create a higher oropharyngeal leak pressure compared with the first generation SADs [4][5][6][7][8] …”

Section: Definitions and Devicesmentioning

confidence: 99%

Supraglottic airways in difficult airway management: successes, failures, use and misuse

Timmermann

2011

Anaesthesia

168

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SummarySupraglottic airway devices (SAD) play an important role in the management of patients with difficult airways. Unlike other alternatives to standard tracheal intubation, e.g. videolaryngoscopy or intubation stylets, they enable ventilation even in patients with difficult facemask ventilation and simultaneous use as a conduit for tracheal intubation. Insertion is usually atraumatic, their use is familiar from elective anaesthesia, and compared with tracheal intubation is easier to learn for users with limited experienced in airway management. Use of SADs during difficult airway management is widely recommended in many guidelines for the operating room and in the pre‐hospital setting. Despite numerous studies comparing different SADs in manikins, there are few randomised controlled trials comparing different SADs in patients with difficult airways. Therefore, most safety data come from extended use rather than high quality evidence and claims of efficacy and particularly safety must be interpreted cautiously.

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A randomized non-crossover study comparing the ProSeal™ and Classic™ laryngeal mask airway in anaesthetized children

Cited by 63 publications

References 15 publications

Comparison of laryngeal mask airway (LMA)-Proseal™ and the LMA-Classic™ in ventilated children receiving neuromuscular blockade

Comparison of laryngeal mask airway (LMA)-Proseal™ and the LMA-Classic™ in ventilated children receiving neuromuscular blockade

Performance of the Pediatric-sized i-gel Compared with the Ambu AuraOnce Laryngeal Mask in Anesthetized and Ventilated Children

Supraglottic airways in difficult airway management: successes, failures, use and misuse

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