title: Randomised, crossover comparison of the single-use SoftSeal and the LMA Unique laryngeal mask airways.
abstract: We performed a randomised, crossover, single-blind trial among 168 patients, to compare the single-use SoftSeal and LMA Unique laryngeal mask airways in spontaneously breathing adults. Size-3 and -4 laryngeal mask airways, inserted by experienced anaesthetists, performed equivalently for successful first-time placement (148 (91%) vs 155 (96%) for the SoftSeal and LMA Unique, respectively). The SoftSeal was more often rated as difficult to insert (27 (17%) vs 4 (3%); p < 0.001) and was more likely to show evidence of mucosal trauma after the first insertion (14 (10%) vs 5 (4%); OR 1.3 (95% CI 1.3-11.3); p < 0.05). The fibreoptic view of the larynx was better through the SoftSeal (vocal cords not visible in 27 (17%) vs 44 (27%); p < 0.05) and it more frequently provided a ventilation seal at 20 cmH(2)O (93 (59%) vs 62 (39%); OR 2.15 (CI 1.44-3.21); p < 0.001). In contrast to the LMA Unique(trade mark), its cuff pressure did not increase during nitrous oxide anaesthesia (median (IQR [range]) decrease 3 (- 20-23 [-40-94]) cmH(2)O vs increase of 16 (-2-39 [-54-112]) cmH(2)O; p < 0.01). Both devices were equivalent for the success of first-time insertion and performed satisfactorily clinically. There were some performance differences, but either appears suitable for airway management in spontaneously breathing patients.
authors.affiliation: Department of Anaesthesia and Pain Medicine, School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia. michael.paech@health.wa.gov.au
authors.forename: M J
authors.initials: MJ
authors.lastname: Paech
authors.forename: O
authors.initials: O
authors.lastname: Tweedie
authors.forename: K
authors.initials: K
authors.lastname: Stannard
authors.forename: M
authors.initials: M
authors.lastname: Hepp
authors.forename: P
authors.initials: P
authors.lastname: Dodd
authors.forename: H
authors.initials: H
authors.lastname: Daly
authors.forename: E-J
authors.initials: EJ
authors.lastname: Bennett
authors.forename: A
authors.initials: A
authors.lastname: Millard
authors.forename: D A
authors.initials: DA
authors.lastname: Doherty
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000295:instrumentation / Q000379:methods; D018592:Cross-Over Studies; D004209:Disposable Equipment; D005260:Female; D006801:Humans; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000293:injuries; D018709:Statistics, Nonparametric