Effect of Continuous Cuff Pressure Regulator in General Anaesthesia with Laryngeal Mask Airway

Abstract

Postoperative pharyngolaryngeal complications (PPLC) occur during anaesthesia due to increased cuff pressure following the insertion of laryngeal mask airways. The use of a pressure regulator to prevent PPLC was evaluated in a prospective, randomized study. Sixty patients scheduled to receive general anaesthesia were randomly assigned to two equal groups of 30, either with or without the regulator. The 'just seal' cuff pressure (JSCP), cuff pressure at 5-min intervals during anaesthesia, incidence of pharyngeal sore throat (PST), dysphagia, dysphonia and other complications were evaluated at 1 and 24 h postoperatively. The combined mean ± SD JSCP of both groups was 20.3 ± 3.2 mmHg. In the group with the regulator, cuff pressure was maintained at a constant level during anaesthesia. This study demonstrated that the regulator is a simple, functional device that can reduce the incidence of PST significantly at 1 h postoperatively, following general anaesthesia.

The Effect of Flurbiprofen on Postoperative Sore Throat and Hoarseness After LMA-ProSeal Insertion: A Randomised, Clinical Trial

“…The LMA was inserted after the patient lost consciousness and eyelash reflex. The LMA size was chosen according to the gender and weight of the patient: size 3 (>50 kg) or size 4 (≤50 kg) for women; size 4 (<70 kg) or size 5 (≥70 kg) for men (11). LMA cuff pressure was adjusted to less than 44 mmHg (12).…”

“…LMA-induced pharyngolaryngeal complications (POST, hoarseness, dysphagia) are related to the insertion technique, number of insertion attempts, LMA size, duration of anaesthesia and surgical position (11,(14)(15)(16). Studies have shown that the use of lubricants to facilitate insertion and cuff pressure control does not reduce the incidence of sore throat (2).…”

Postoperative sore throat: a systematic review

“…Smaller tube size [5][6][7] Use of i-gel [50,[63][64][65] SAD rather than tracheal tube [121,122] Video laryngoscopy [9,10] 90°rotational insertion technique, use of introducing stylet for ProSeal LMA laryngeal mask [81][82][83][84][85] Oral rather than nasotracheal intubation [124] Limiting cuff pressure [32][33][34] Cuff pressure limitation ≤ 60 cmH 2 O [88][89][90][91][92][93]96] Cuffed rather than uncuffed tubes [125] Intravenous, topical or inhaled steroids [22][23][24][25] Topical steroids, NSAIDs, tramadol [98,101,102] Limiting tracheal tube cuff pressure [126] Topical NSAIDs [27][28][29]31] Propofol induction and maintenance [106,107] SAD cuff pressure limitation ≤ 60 cmH 2 O [130][131][132][133] Liquorice, magnesium and ketami...…”

Fewer sore throats and a better seal: why routine manometry for laryngeal mask airways must become the standard of care

“…These may result from both increased mucosal pressure and the failure to conform to the contours of the larynx, pharynx and oesophagus. Published adverse effects include recurrent laryngeal nerve palsy , dysphonia, dysphagia and venous congestion , with its attendant risks of airway oedema and surgical bleeding.…”