A cohort evaluation of the pediatric ProSeal laryngeal mask airway in 100 children.
BACKGROUND
The ProSeal laryngeal mask airway (PLMA) has been available in pediatric sizes in the UK since 2007. Although several non-UK studies have evaluated PLMAs in children, there are little published data regarding their use in this country. Having decided to introduce the pediatric PLMA into our practice, we chose to prospectively audit the first 100 uses as part of our clinical governance.


METHODS
We studied children undergoing elective surgery who were considered suitable for a supraglottic airway. We recorded patient, surgical and insertion details, device performance data and complications. Patient management was not altered by inclusion in this audit.


RESULTS
Twenty size 1.5, 55 size 2.0, 15 size 2.5 and 10 size 3.0 PLMAs were inserted in 100 consecutive children [median age 2 years (range 2 months to 10 years) and median weight 15 kg (range 4.9-60 kg)]. The overall first attempt success rate was 93% (size 1.5, 100%; size 2.0, 100%; size 2.5, 87%; size 3.0, 90%) and overall successful insertion rate was 99%. Median leak pressure was 25 cmH(2)O. Outright failure was seen in one patient; complications were seen in another six patients (partial airway obstruction in five patients and mild laryngospasm in one patient), all of whom were transient and none of whom required intubation. No episodes of regurgitation were recorded.


CONCLUSIONS
Even without prior experience and using nonconventional insertion, pediatric PLMAs (including size 1.5) can be easily inserted and provide an effective airway.
Kelly
Fiona
F
Department of Anaesthesia, Bristol Royal Hospital for Children, Bristol, UK.
Sale
Steven
S
Bayley
Guy
G
Cook
Tim
T
Stoddart
Peter
P
White
Michelle
M
D000293:Adolescent; D000399:Air Pressure; D000769:Anesthesia, Inhalation; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017558:Elective Surgical Procedures; D004867:Equipment Design; D006801:Humans; D007223:Infant; D017214:Laryngeal Masks / Q000009:adverse effects*; D008485:Medical Audit; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods