title: A comparison of four methods for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA) in paediatric patients.
abstract: BACKGROUND
  This study compares four tests for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA). We tested the hypothesis that the oropharyngeal leak pressure and interobserver reliability differs between tests.
  
  
  METHODS
  Eighty paralysed anaesthetized paediatric patients (weight 10-30 kg) were studied with the intracuff pressure set at 60 cmH2O. Four different oropharyngeal leak pressure tests were performed in random order on each patient by two observers blinded to each other's measurements. Test 1 involved detection of an audible noise. Test 2 involved detection of endtidal CO2 in the oral cavity. Test 3 involved observation of the aneroid manometer dial as the pressure increased and noting the airway pressure at which the dial reaches stability. Test 4 involved detection of an audible noise by neck stethoscopy.
  
  
  RESULTS
  The mean oropharyngeal leak pressure was 12.5 cmH2O and was similar between tests. The intraclass correlation coefficient was 0.99 for all tests and was classed as excellent.
  
  
  CONCLUSIONS
  We conclude that all four tests provide accurate and reliable information about oropharyngeal leak pressure in children.
authors.affiliation: Department of Anaesthesia and Reanimation, Maranon University Hospital, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Lopez-Gil
authors.forename: J
authors.initials: J
authors.lastname: Brimacombe
authors.forename: C
authors.initials: C
authors.lastname: Keller
mesh_terms: D000399:Air Pressure; D000769:Anesthesia, Inhalation; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D017214:Laryngeal Masks; D008297:Male; D009960:Oropharynx / Q000502:physiology; D016683:Supine Position / Q000502:physiology