The LMA^® Protector^TM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study

Abstract

We evaluated the LMA â Protector TM in 280 ASA physical status 1-3 patients aged 18-75 years by assessing the ease of insertion, insertion time, oropharyngeal leak pressure, ease of gastric tube passage and complications. First-attempt and overall insertion success was 234/280 (84; 95%CI 79-88%) and 274/280 (98; 95-99%). Median (IQR [range]) insertion time was 17 (12-25 [5-44]) s, and manoeuvres to facilitate insertion were required in 56 (50-63)% of patients. Median oropharyngeal leak pressure was 31 (26-36 [14-40]) cmH 2 O. Multivariate analysis identified two risk factors for oropharyngeal leak pressure < 25 cmH 2 O: male sex (OR 2.44; 1.01-5.91, p = 0.048) and the insertion of a LMA size different to that recommended by weight (OR 1.98; 0.97-4.03, p = 0.06). Gastric tube insertion was possible in 256 out of 274 patients (93%). On fibreoptic view, vocal cords were visible in 86% of patients. During maintenance, 14 patients (5%) required airway manipulation. There were no episodes of regurgitation or aspiration. Blood staining on LMA removal was present in 70 out of 280 patients (25%). Use of the LMA Protector appears safe and is associated with a high success rate, provision of a highly effective seal and low rates of clinical complications. These attributes would suggest considerable potential for use during anaesthesia.

LMA ® Protector™ In Patients Undergoing Laparoscopic Surgeries: A Multicenter Prospective Observational Study

“…The mean oropharyngeal leak pressure of LMA® Protector™ in our study was 30 cmH 2 O, which was in keeping with the previous ndings on LMA® Protector™ by Zaballos, M., (21) and van Zundert(18). The oropharyngeal leak pressure of 30 cmH 2 O was better than most of the other LMAs that were commonly used in clinical practice and meet the needs of laparoscopic surgeries.…”

“…However, our ndings suggested that attention should be given to gastroesophageal regurgitation especially under head-down positions and adequate suction should be conducted before removal of SADs. The incidence of sore throat (25.86%) observed in our study on the rst day after surgery was relatively higher in comparison with 6% in Zaballos, M.'s study (21) and 23.1% in Sng's study. (13) However, all 75 patients experienced mild symptoms and recovered without any further intervention.…”

Comparison of intragastric pressure between endotracheal tube and supraglottic airway devices in laparoscopic hepatectomy

“…Air was insufflated into the SGA cuff until the pilot balloon black line was located within the green zone. [ 10 ] After successful ventilation was confirmed on capnography, mechanical ventilation was started. Cuff pressure of the SGA was adjusted using a digital cuff pressure monitor (Shiley Pressure Control, Covidien, Germany) to maintain ≤60 cm H 2 O. SGA devices were replaced by ETTs in the following situations for patient safety if the SGA was not inserted in >3 attempts, persistent oropharyngeal leak with inadequate ventilation (end-tidal CO 2 ≥45 mm Hg during pneumoperitoneum), and/or the stomach was inflated enough to cause visual disturbance under laparoscopic view.…”

The case for a 3rd generation supraglottic airway device facilitating direct vision placement

“…the 'worst that can happen' [53]. Zaballos et al [54] recently conducted a multicentre, prospective, observational study in 280 non-paralysed patients with 'easy' airways. The then newly introduced LMA-Protec-tor® (Teleflex™ Medical Europe, Westmead, Ireland) was inserted blind.…”