Type of Article: Original Research

Volume 5; Issue 9: 2018

Page No.: 741-745

DOI: 10.16965/ijims.2018.135

EASE OF INSERTION, MAINTENANCE OF AIRWAY AND RISK OF INJURY ARE SIMILAR BETWEEN THE LMA-PROSEAL AND THE LMA-CLASSIC IN CHILDREN

Ch Anil Kumar 1, D Sandeep Kumar 1, Srinivas2, Shanti Raj *3.

1 Assistant professor in Anaesthesia, Viswa Bharthi Medical College, Kurnool, Andhra Pradesh, India.

2 Senior Resident in Anaesthesia, Viswa Bharthi Medical College, Kurnool, Andhra Pradesh, India.

*3 Associate professor in Anaesthesia, Viswa Bharthi Medical College, Kurnool, Andhra Pradesh, India.

Corresponding author: Dr. Shanti Raj, Associate professor in Anaesthesia, Viswa Bharthi Medical College, Kurnool, Andhra Pradesh, India. E-Mail: shantirajgunna123@gmail.com, thalithakumidhanya@gmail.com

Abstract:

Background: The LMA-Classic is a first generation supraglottic airway device, with largest evidence base for efficacy and safety, and is considered benchmark against which newer LMA are judged. The LMA-ProSeal is a second generation supraglottic airway device with modified cuff and drainage tube, designed for better seal with both the respiratory and gastrointestinal tracts, notwithstanding the access to the alimentary tract. This study compared is planned to compare efficacy of the LMA-Classic and LMA-ProSeal in children undergoing elective surgery under general anaesthesia.

Materials and method: This comparative study was done during the period of 01–Jan – 2018 to 30–aug–2018 in Viswa Bharthi Institute of Medical Sciences in the Department of Anaesthesiology with 40 ASA 1-2 children undergoing circumcision, herniotomy and orchiopexy were included. The patients were randomly assigned to size 2.5 LMA-ProSeal or 2.5 LMA-Classic groups for airway management. We assessed success rates at first attempt of insertion, airway sealing pressure, maintenance of airway and postoperative complications.

Results: There was no statistical difference between two groups for the success rates at first attempt of insertion and maintenance of airway but sealing pressure was significantly high in the LMA-ProSeal group. Regarding postoperative complication like injury to lip-teeth-tongue, blood staining and cough or laryngospasm were also not significant.

Conclusion: the ease of insertion, maintenance of airway and risk of injury are similar between the LMA-ProSeal and the LMA-Classic in children.

Key words: Paediatric anaesthesia, Equipment, Laryngeal mask airway.

REFERENCES

  1. Michelle C. White, Tim M. Cook, Peter A. Stoddart. A critique of elective pediatric supraglottic airway devices. Pediatric Anesthesia 2009 19 (Suppl. 1): 55–65.
  2. Efrat R, Kadari A, Katz. The laryngeal mask airway in pediatric anesthesia: experience with 120 patients undergoing elective groin surgery. J Pediatr Surg. 1994 Feb;29(2):206-8.
  3. Bhavesh Patel, Robert Bingham. Laryngeal mask airway and other supraglottic airway devices in paediatric practice Contin Educ Anaesth Crit Care Pain February 1, 2009 9:6-9.
  4. Goldmann K, Jakob C. A randomized crossover comparison of the size 2 1/2 laryngeal mask airway ProSeal versus laryngeal mask airway-Classic in pediatric patients. Anesth Analg. 2005 Jun;100(6):1605-10.
  5. Brain AI. The development of the Laryngeal Mask–a brief history of the invention, early clinical studies and experimental work from which the Laryngeal Mask evolved. Eur J Anaesthesiol Suppl 1991; 4: 5–17.
  6. Brain AI, Verghese C, Strube PJ. The LMA ProSeal – a laryngeal mask with an oesophageal vent. Br J Anaesth. 2000 ; 84 (5): 650-4.
  7. Lopez-Gil M, Brimacombe J, Garcia G. A randomized non-crossover study comparing the ProSeal and Classic laryngeal mask airway in anaesthetized children. Br J Anaesth. 2005 Dec;95(6):827-30.
  8. Kanthed P, Sharma B, Sood J, Kumra VP. Comparison of LMA-ProSealTM with LMA ClassicTM in Anaesthetised Paralysed Children. Indian J Anaesth 2008;52:44.
  9. Goldmann, C. Jakob. Size 2 ProSeal™ laryngeal mask airway: a randomized, crossover investigation with the standard laryngeal mask airway in paediatric patients. Br J Anaesth. 2017;94(3):385-389.
  10. Shimbori, K. Ono, T. Miwa, N. Morimura, M. Noguchi, K. Hiroki. Comparison of the LMA-ProSeal™ and LMA-Classic™ in children. Br J Anaesth. 93(4): 528-531.
  11. Brimacombe J, Keller C. The ProSeal Laryngeal Mask Airway: A Randomized, Crossover Study with the Standard Laryngeal Mask Airway in Paralyzed, Anaesthetized Patients. Anesthesiology. 2000;93:104-109.
  12. Brimacombe J, Keller C, Fullekrug B, Agrò F, Rosenblatt W, Dierdorf SF, et al. A Multicenter  Study Comparing the ProSeal and Classic Laryngeal Mask Airway in Anesthetized, Nonparalyzed Patients. Anesthesiology. 2002;96:289-95.
  13. Cook TM, Nolan JP, Verghese C, Strube PJ, Lees M, Millar JM, et al. Randomized Crossover Comparison of the Proseal with the Classic Laryngeal Mask Airway in Unparalyzed Anaesthetized Patients. Br J Anaesth. 2002;88:527-33.
  14. Lopez-Gil M, Brimacombe J. Pulmonary Evaluation of a New Prototype Laryngeal Mask Airway in Children. Br J Anaesthe. 1999;82:132-34.
  15. Lopez-Gil M, Brimacombe J, Keller C. A Comparison of Four Methods for Assessing Oropharyngeal Leak Pressure with the Laryngeal Mask Airway in Pediatric Patients. Pediatric Anaesth. 2001;11:319-21.

Download Full Text TOC