A randomized controlled trial comparing the ProSeal Laryngeal Mask Airway with the Laryngeal Tube Suction in mechanically ventilated patients.
BACKGROUND
The ProSeal Laryngeal Mask Airway (PLMA) (Laryngeal Mask Company, Henley-on-Thames, United Kingdom) is a new laryngeal mask with a modified cuff designed to improve its seal and a drain tube for gastric tube placement. Similarly, the Laryngeal Tube Suction (LTS) (VBM Medizintechnik Gmbh, Sulz a.N, Germany) is a new laryngeal tube that also has an additional channel for gastric tube placement. This study compared the placement and functions of these two devices.


METHODS
One hundred fifty patients undergoing general anesthesia for elective surgery were randomly allocated to the PLMA (n = 75) or LTS (n = 75). Oxygenation and ventilation, ease of insertion, fiberoptic view, oropharyngeal leak pressure, ventilatory data, ease of gastric tube insertion, and postoperative airway morbidity were determined.


RESULTS
After successful insertion of the devices in 96% of patients with the PLMA and in 94.4% with the LTS it was possible to maintain oxygenation, ventilation, and respiratory mechanics during the entire duration of surgery. Successful first and second attempt insertion rates were 57 patients (76%) and 15 patients (20%), respectively, for the PLMA and 60 patients (80%) and 11 patients (14.6%), respectively, for the LTS. Airway placement was unsuccessful with the PLMA in three patients and with the LTS in four patients. Time to achieve an effective airway was 36 +/- 24 s with the PLMA versus 34 +/- 25 s with the LTS. Gastric tube insertion was possible in 97.3% of patients with the PLMA and in 96% with the LTS.


CONCLUSIONS
With respect to both physiologic and clinical function, the PLMA and LTS are similar and either device can be used to establish a safe and effective airway in mechanically ventilated anesthetized adult patients.
Anesthesia Department, Bnai-Zion Medical Center, Haifa, Israel. gaitini@netvision.net.il
Luis A
LA
Gaitini
Sonia J
SJ
Vaida
Mostafa
M
Somri
Boris
B
Yanovski
Bruce
B
Ben-David
Carin A
CA
Hagberg
D000328:Adult; D000368:Aged; D000399:Air Pressure; D000769:Anesthesia, Inhalation / Q000295:instrumentation*; D001999:Bronchoscopy; D002245:Carbon Dioxide / Q000378:metabolism; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007441:Intubation, Gastrointestinal; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011183:Postoperative Complications / Q000453:epidemiology; D012121:Respiration, Artificial; D012137:Respiratory System / Q000293:injuries; D013396:Suction / Q000295:instrumentation; D016896:Treatment Outcome
D002245:Carbon Dioxide; D010100:Oxygen