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. 2014 Apr;30(2):177-82.
doi: 10.4103/0970-9185.130005.

ProSeal laryngeal mask airway™ insertion in the prone position: Optimal utilization of operation theatre personnel and time?

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ProSeal laryngeal mask airway™ insertion in the prone position: Optimal utilization of operation theatre personnel and time?

Bimla Sharma et al. J Anaesthesiol Clin Pharmacol. 2014 Apr.

Abstract

Background: Positioning an anesthetized patient prone is challenging with regard to manpower requirement, time to surgical readiness and airway management. The ProSeal laryngeal mask airway™ (PLMA) is emerging as a suitable alternative, both as a primary and a rescue airway device to the tracheal tube (TT) for patients undergoing surgery in the prone position.

Materials and methods: In this prospective randomized study, 70 patients scheduled to undergo pilonidal sinus excision in prone position were allocated to two groups of 35 patients each, depending on the position of the patient at induction and device placement: Group S (device placed while supine) and Group P (device placed while prone). We compared the manpower requirement, time to surgical readiness, efficacy and safety of the PLMA for airway management in the two groups.

Results: The number of personnel [5 (4-6) vs. 3 (3-3); P < 0.001] required for positioning the patient and surgical readiness time (22.1 ± 3 vs. 5.9 ± 0.9 min; P < 0.001) was higher in group S. There was no difference between the two groups with regard to efficacy and safety of the PLMA. Incidence of blood on the PLMA cuff and sore throat was comparable in the two groups (P = 1.000).

Conclusion: We conclude that induction and placing the PLMA in the prone position by experienced users require fewer personnel and reduces surgical readiness time.

Keywords: Equipment; ProSeal laryngeal mask airway; prone position; technique.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
CONSORT 2012 flow diagram
Figure 2
Figure 2
ProSeal LMA insertion in Prone Position, (a) Self positioned patient in prone position. A trolley can be seen along side the OT table, (b) Preoxygenation in the prone position with the anesthesiologist standing at head end and showing the PLMA with the gastric tube coming out of the drain tube, (c) Digital insertion of PLMA, (d) Secured PLMA with gastric tube in situ and a cuff pressure monitor

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