title: A clinical evaluation of four disposable laryngeal masks in adult patients.
abstract: OBJECTIVE
  To compare the clinical use of four disposable laryngeal masks (DLMs): the Ambu laryngeal mask [Ambu LM], Solus, Laryngeal Mask Airway (LMA) Unique, and Soft Seal.
  
  
  METHODS
  Prospective, randomized study.
  
  
  METHODS
  Operating room and recovery area of a university-affiliated ambulatory surgery unit.
  
  
  METHODS
  200 adult ASA physical status I, II, and III patients, scheduled for ambulatory procedures.
  
  
  METHODS
  Patients underwent insertion of the DLM by nonexperienced residents.
  
  
  METHODS
  The time and number of attempts needed for insertion, quality of ventilation, airway sealing pressure at 60 cmH(2)O of intracuff pressure, and complications were all evaluated.
  
  
  RESULTS
  Ease of insertion was greater (P = 0.03) and first attempt success rate was higher with the Ambu LM (78%) and LMA Unique (80%). The Solus most often needed three attempts to be placed (12 cases); the Ambu LM needed three similar attempts in two cases; the LMA Unique in 4 cases; and the Soft Seal in 5 cases (P = 0.018). The LMA Unique achieved the highest rate of optimal ventilation (46/49 cases) of the 4 groups. Airway sealing pressure was significantly higher with the Soft Seal (27.3 +/- 5 mmHg), compared to the Ambu LM (23.7 +/- 5 mmHg), the Solus (20.9 +/- 4 mmHg), and the LMA Unique (22.1 +/- 6 mmHg) (P < 0.001). Blood staining of the DLM on removal was most frequent with the Soft Seal (38%).
  
  
  CONCLUSIONS
  The Ambu LM and LMA Unique DLMs appear to be easier to insert by inexperienced residents and are less traumatic for the patient. The Soft Seal achieves a higher airway seal than other devices, but it causes more mucosal trauma. The Solus had the highest insertion failure rate of the 4 groups.
authors.affiliation: Department of Anesthesiology and Reanimation, Hospital Clínic of Barcelona, University of Barcelona, Spain. analopez@clinic.ub.es
authors.forename: Ana M
authors.initials: AM
authors.lastname: López
authors.forename: Ricard
authors.initials: R
authors.lastname: Valero
authors.forename: Paula
authors.initials: P
authors.lastname: Bovaira
authors.forename: Montserrat
authors.initials: M
authors.lastname: Pons
authors.forename: Xavier
authors.initials: X
authors.lastname: Sala-Blanch
authors.forename: Teresa
authors.initials: T
authors.lastname: Anglada
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004209:Disposable Equipment; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000209:etiology / Q000517:prevention & control; D012119:Respiration; D013997:Time Factors; D016896:Treatment Outcome