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Randomized Comparative Study of Proseal Laryngeal Mask Airway and Classic Laryngeal Mask Airway for Airway Management

Tushar Bhavar, Assistant Professor, Dept. of Anesthesia & Critical Care, Rural Medical College Loni. , Banreet Bagri1 , Tushar D. Bhavar2 , Parmod Kumar3 , J.P.S. Bhupal4

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Indian Journal of Anesthesia and Analgesia 4(3):p 673-677, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.21

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Abstract

Background: Laryngeal mask airways(LMA) have many advantages over endotracheal intubation in airways management, but has a risk of gastric insufflations, vomiting and aspiration. The aim of our study was to know how effective and safe ProSeal laryngeal mask airway (PLMA) is as compared to Classic laryngeal mask airway (CLMA) when used for adult patients posted for elective surgery under general anaesthesia using muscle relaxants. Methods: Study was conducted in a tertiary care teaching government institute.Sixty American Society of Anesthesiologists (ASA) I and II patients of either sex in the age group of 18–60 years who were scheduled for an elective surgery with general anesthesia were included in study and were divided randomly to either proseal laryngeal mask airway (PLMA) or classic laryngeal mask airway (CLMA) group. Both group patients received same induction, maintenance and reversal medications. Insertion success rates and attempts, time required to secure the device, oropharyngeal leak pressure, intra-operative & post-operative complications were observed and compared using statistical software Graph Pad Prism 6.01. Results: No significant difference was observed in the number of insertion attempts, success rates of insertion, intraoperative and post-operative complications amongst the two groups. The classic laryngeal mask airway was quicker to insert as compared to the PLMA. The PLMA provided a better airway seal as shown by the oropharyngeal leak pressure. The mean oropharygeal leak pressure in PLMA group was 26.45±1.41 cm H2O and in CLMA group it was 17.43±1.17 cm H2O. Conclusions: In anesthetised, paralyzed patients CLMA is easier as well as quicker to insert, but more effective seal was found when PLMA was used. Comparing the incidence of intraoperative complications and postoperative complications it was found to be similar.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.21

Keywords

Laryngeal Mask; Aspiration of Gastric Contents; ProSeal LMA™; Endotracheal Intubation; General Anaesthesia; Cuff Pressure. 

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