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. 2020 Apr-Jun;36(2):227-232.
doi: 10.4103/joacp.JOACP_332_19. Epub 2020 Jun 15.

Comparison of leakage test and ultrasound imaging to validate ProSeal supraglottic airway device placement

Sachin E Ajithan  1 , Archana Puri  1 , Mukul C Kapoor  1
Affiliations

Comparison of leakage test and ultrasound imaging to validate ProSeal supraglottic airway device placement

Sachin E Ajithan et al. J Anaesthesiol Clin Pharmacol. 2020 Apr-Jun.

Abstract

Background and aims: To validate the placement of ProSeal supraglottic airway device using ultrasound (USG) with leakage test in adult population of both sexes.

Material and methods: This single-arm observational study was conducted on 80 American Society of Anesthesiology (ASA) I-III patients, undergoing elective surgery under general anesthesia with ProSeal supraglottic airway device. Leakage pressure test was conducted in all cases. The position of the ProSeal laryngeal mask airway (LMA) was assessed by USG in the pharyngeal, laryngeal, and the cranial-caudal axis plane. The fiberoptic examination was done to confirm the position of ProSeal if the seal pressure was <27 cm H2O, to confirm suboptimal placement. The position of the ProSeal in the three USG planes was allocated a predetermined score. This score was compared with the leakage test to determine the strength of the correlation, sensitivity, and specificity for predicting a need for reinsertion.

Results: Leakage seal pressure was recorded as <27 cm H2O in 6 (7.5%) patients and fiberoptic bronchoscopy was done in these cases to determine the need for reinsertion. ProSeal was reinserted in 5 (6.25%) cases. Patients with a composite ultrasound score of 0-1 required ProSeal reinsertion while those with a score of 2-3 did not require reinsertion. Seventy-one patients had seal pressure >27 cm H2O and a score of 3. USG examination is comparable with leakage test in predicting the requirement of reinsertion (P = 0.003) and a score of 19 equating 0-1 predicted the need for reinsertion with a sensitivity and specificity of 80% and 100%, respectively.

Conclusion: USG is comparable with the leakage test for confirmation of ProSeal placement.

Keywords: Cuff pressure; ProSeal supraglottic airway device; fiberoptic examination; leakage test; ultrasound imaging.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Figure showing the three planes in which ultrasound airway examination was done with the image viewed and the score allowed to different views
Figure 2
Figure 2
The view of the larynx on fiberoptic examination through the ProSeal showing the optimal and suboptimal views
Figure 3
Figure 3
Spearman's Rank Correlation (rho) analysis of Ultrasound score and seal pressure by leakage test
See this image and copyright information in PMC

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