title: Randomized evaluation of the single-use SoftSeal and the re-useable LMA Classic laryngeal mask.
abstract: A number of laryngeal masks are available, including both re-usable and single-use masks. Single-use laryngeal masks may decrease the risk of transmitting prion infections. We performed a single-blind randomized trial in 200 spontaneously breathing female patients under general anaesthesia with nitrous oxide, to compare a new single-use laryngeal mask, the SoftSeal (Portex Ltd, U.K.), with a re-usable laryngeal mask, the LMA Classic (Laryngeal Mask Company Ltd., Cyprus). The primary outcome was successful insertion at the first attempt. Size 4 single-use (n = 99) or re-usable (n = 100) laryngeal masks, inserted by experienced anaesthetists, were equivalent for successful placement at the first attempt (90% versus 91% respectively). The single-use mask was less easy to insert (47% difficult versus 9%, P < 0.001). Clinical and anatomical tests of position and function were similar. The cuff pressure of the re-usable mask increased significantly compared with the single-use mask (median +10 cm versus -2 cm H2O, P < 0.001). Forty per cent of patients allocated the single-use mask and 20% of those allocated the re-usable mask experienced sore throat at 24 hours postoperatively (P < 0.05). An estimation of cost per patient use was greater for the re-usable mask. We conclude that the SoftSeal single-use laryngeal mask and the LMA Classic re-usable laryngeal mask airway are of similar clinical utility in terms of successful insertion and airway maintenance. The re-usable laryngeal mask was easier to insert and associated with less postoperative sore throat, but costs were higher.
authors.affiliation: Department of Anaesthesia and Pain Management, King Edward Memorial Hospital for Women, Royal Perth Hospital, Perth, W.A.
authors.forename: M J
authors.initials: MJ
authors.lastname: Paech
authors.forename: J
authors.initials: J
authors.lastname: Lain
authors.forename: W R
authors.initials: WR
authors.lastname: Garrett
authors.forename: G
authors.initials: G
authors.lastname: Gillespie
authors.forename: K J
authors.initials: KJ
authors.lastname: Stannard
authors.forename: D A
authors.initials: DA
authors.lastname: Doherty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D017214:Laryngeal Masks / Q000009:adverse effects / Q000191:economics; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010612:Pharyngitis / Q000209:etiology; D016037:Single-Blind Method