The Laryngeal Mask Airway Unique??? versus the Soft Seal??? Laryngeal Mask: A Randomized, Crossover Study in Paralyzed, Anesthetized Patients

Abstract

We tested the hypothesis that ease of insertion, oropharyngeal leak pressure, fiberoptic position, ease of ventilation, and mucosal trauma are different for the Soft Seal laryngeal mask airway (SSLM) and the laryngeal mask airway Unique (LMA-U). Ninety paralyzed, anesthetized adult patients (ASA I-II; 18-80 yr old) were studied. Both devices were inserted into each patient in random order. Oropharyngeal leak pressure and fiberoptic position were determined during cuff inflation from 0-40 mL in 10-mL increments and at an intracuff pressure of 60 cm H(2)O. Ease of ventilation was determined by controlling ventilation for 10 min at 8 and 12-mL/kg tidal volume and recording hemoglobin oxygen saturation, end-tidal CO(2), leak fraction, peak airway pressure, and the presence or absence of gastric insufflation. Mucosal trauma was determined by examining the first randomized device for the presence of visible and occult blood. Insertion time was shorter (P = 0.0001) and fewer attempts were required (P = 0.005) for the LMA-U. There were no failed uses of either device. Oropharyngeal leak pressures were similar, but fiberoptic position was superior with the LMA-U (P < or = 0.0003). There were no differences in hemoglobin oxygen saturation, end-tidal CO(2), leak fraction, or peak airway pressure at either tidal volume. Gastric insufflation was not detected in either group at either tidal volume. The frequency of visible (P = 0.009) and occult blood (P = 0.0001) was less with the LMA-U. We conclude that the LMA-U is superior to the SSLM in terms of ease of insertion, fiberoptic position, and mucosal trauma, but similar in terms of oropharyngeal leak pressure and ease of ventilation.

Randomised crossover comparison of the Ambu® AuraOnceTM Laryngeal Mask with the LMA ClassicTM laryngeal mask airway in paralysed anaesthetised patients*

“…Our study found no correlation between the fibreoptic position and the functioning of these devices. This has also been demonstrated in other studies [13,14]. The absence of the aperture bars has not been found to influence the fibreoptic position; instead it may allow easier passage of instruments through the device into the respiratory tract and hence facilitate passage of a fibreoptic endoscope [5].…”

Uso da abordagem lateral para introdução de máscara laríngea durante craniotomia em paciente acordado: relato de caso

“…The thumb was used as a guide, squeezing the tube of the mask against the palate while introducing it with the other hand. In this case, the contamination of the surgical field was avoided and the insertion was successful in the first attempt, although it is considered more difficult than the cephalic approach 15,16 . The use of the "awake-asleep-awake" anesthetic technique with continuous infusion of remifentanil and propofol provided hemodynamic stability, complete awakening in a short time, and the patient remained cooperative for the aphasia test.…”

“…Usou-se o dedo polegar como guia, comprimindo o tubo da máscara laríngea contra o palato, enquanto realizava-se a sua progressão com a outra mão. Nesse caso, evitou-se a contaminação do campo cirúrgico e a inserção foi bem-sucedida na primeira tentativa, embora seja considerada mais difícil do que a abordagem cefálica 15,16 . O uso da técnica "dormindo-acordado-dormindo", com infusão contínua de remifentanil e propofol nesse caso, propor-…”

A randomised crossover trial comparing a single‐use polyvinyl chloride laryngeal mask airway with a single‐use silicone laryngeal mask airway

“…No prior data were available regarding success rates for insertion of either device. Brimacombe et al reported the first-time success rate for insertion of the Portex Soft Seal TM Laryngeal Mask to be 80% and that of the LMA Unique Ò to be 89% [17] (both examples …”