Laryngeal tube S II, ProSeal laryngeal mask, and EasyTube during elective surgery: a randomized controlled comparison with the endotracheal tube in nontrained professionals

Abstract

Background and objective: EasyTube (EZT), ProSeal laryngeal mask airway (PLMA), and Laryngeal tube S II (LTS II) have recently been introduced as supraglottic airway devices and have been proposed as emergency airway alternatives. The purpose of this study was to compare the performance of the three devices, if used by anaesthesiologists without extensive hands-on training, with the endotracheal tube during routine surgical procedures.

Methods: After informed consent, 88 ASA I-II patients scheduled for routine minor surgery were randomly allocated to EZT (n=22), PLMA (n=22), and LTS II (n=22) groups and the endotracheal tube (n=22) group, respectively. Overall success rates, insertion times, cuff pressures, and resulting airway leak pressures as well as subjective assessment of handling were determined.

Results: Overall insertion success rate of the EZT, PLMA, LTS II, and endotracheal tube was 14 out of 22 (64%), 20 out of 22 (91%), 21 out of 22 (96%), and 21 out of 22 (96%), respectively. Time to first successful ventilation with the EZT was significantly (P<0.05) longer than that with PLMA, LTS II, and endotracheal tube [median (minimum-maximum): 56 (27-150), 25 (12-70), 24 (11-150), and 20 (8-74) s, respectively]. The lowest airway leak pressure could be observed with the EZT [median (minimum-maximum), 19 (9-40) cmH2O] and the highest airway leak pressure with the LTS II [median (minimum-maximum), 40 (22-40) cmH2O]. Subjective assessment of handling was significantly (P<0.05) poorer in the EZT group compared with PLMA, LTS II, and endotracheal tube groups, respectively.

Conclusion: In contrast to the EZT, both PLMA and LTS II proved to be suitable for routine airway management by anaesthesiologists without extensive hands-on device training.