[First clinical impressions of ProSeal laryngeal mask]

Abstract

ProSeal laryngeal mask airway (PLMA, LMA-ProSeal) is a newly developed laryngeal mask airway intended to overcome two major disadvantages of the conventional laryngeal mask airway, i.e., poor protection of the airway from gastric regurgitation and low sealing effect around the laryngeal inlet. The new PLMA can provide air-tight sealing by a second cuff positioned at the back of the mask and a bypass channel for the alimentary tract by a second tube (drain tube) opening at the tip of the mask. However, clinical feature of this new device has been assessed by few authors. Forty adult patients (19 males and 21 females) under general anesthesia immobilized with vecuronium were included in this study. A PLMA size 4 was inserted with (n = 10) or without (n = 30) an introducer at first (n = 37), second (n = 2) or third (n = 1) attempt and clear airway was obtained in all patients. After placing the PLMA in 10 patients (5 males and 5 females) sealing pressure was measured at cuff pressure of 0, 20, 40 and 60 cmH2O and at completely deflated cuff state. Averaged seal pressure at the 60 cm H2O cuff pressure was 22.7 +/- 8.0 cmH2O in the all 40 patients. Averaged seal pressure was higher in female than in male at all cuff pressure. The average seal pressure was 15.1 cmH2O even when the cuff was deflated completely. A lubricated 16-French gastric tube was inserted easily through the drain tube in all patients except one in which the mask was found to be deflected backward. There were no significant complications related to the PLMA. We concluded that the PLMA can provide high sealing pressure and isolate the airway from the alimentary tract. Further study including adverse effect of the high sealing effect should be required.