[Use of the size 3 ProSeal laryngeal mask airway in children. Results of a randomized crossover investigation with the Classic laryngeal mask airway].
BACKGROUND
The low-pressure airway seal of the Classic laryngeal mask airway (CLMA) can be inadequate for positive pressure ventilation (PPV) in children. The ProSeal laryngeal mask airway (PLMA) forms a more effective seal of the airway than the CLMA and facilitates gastric tube placement in adults. The size 3 PLMA can be used in adults and children.


METHODS
The CLMA and PLMA were studied in random order -- crossover -- in 30 anaesthetized, non-paralysed children (average age 10.6 years, average body weight 39 kg). Airway leak pressure, maximum tidal volume, ease of insertion, quality of initial airway and fiberoptic position were determined. Gastric tube placement was assessed for the PLMA.


RESULTS
The mean airway leak pressure in neutral head position (27.0 vs. 16.8 cm H(2)O), maximum flexion (38.3 vs. 26.2 cm H(2)O) and maximum extension (21.1 vs. 14.2 cm H(2)O) as well as the mean maximum tidal volume (1432 vs. 1062 ml) were significantly higher (p<0.001) for the PLMA. Air insufflation into the stomach occurred with the CLMA but not with the PLMA. Gastric tube placement was possible in all patients.


CONCLUSIONS
The high reliability of g-tube placement and the significantly increased airway leak pressure seem to make the size 3 PLMA a more suitable device for PPV in children than the same size CLMA.
Goldmann
K
K
Klinik für Anästhesie und Intensivtherapie, Philipps-Universität, Marburg. Kaigoldmann1@aol.com
Roettger
C
C
Wulf
H
H
D000293:Adolescent; D000399:Air Pressure; D000769:Anesthesia, Inhalation / Q000295:instrumentation*; D002648:Child; D018592:Cross-Over Studies; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007327:Insufflation; D007441:Intubation, Gastrointestinal; D017214:Laryngeal Masks / Q000009:adverse effects; D007828:Laryngoscopy; D008297:Male; D012121:Respiration, Artificial / Q000295:instrumentation*; D013270:Stomach / Q000502:physiology; D013990:Tidal Volume