title: A prospective randomized trial comparing supraglottic airways for flexible bronchoscopy in children.
abstract: OBJECTIVE
  A prospective randomized, controlled trial was conducted comparing supraglottic airways (SGA) for flexible bronchoscopy in 100 children.
  
  
  BACKGROUND
  Pediatric flexible bronchoscopy is commonly performed using a SGA as both a ventilation device and a conduit for flexible bronchoscopy. We observed that some disposable SGAs were associated with increased resistance to bronchoscope manipulation compared to the LMA Classic (cLMA).
  
  
  METHODS
  We compared the cLMA to the Ambu Aura Once, Portex Soft Seal, Boss Systems disposable silicone laryngeal mask, and LMA Unique. We recorded the subjective resistance of the bronchoscope manipulation within the SGA by linear analog score and measured the time to insert the bronchoscope from the proximal end of the SGA to the right upper lobe. We also scored the view of the larynx through the bronchoscope and measured SGA cuff pressures.
  
  
  RESULTS
  Resistance to bronchoscope manipulation during pediatric flexible bronchoscopy was higher using polyvinyl chloride (PVC) disposable SGAs (Ambu, Unique, and Portex) than the silicone re-usable cLMA (P < 0.0001). The Unique and Ambu laryngeal masks were clinically inferior to the cLMA at all levels of the airway (P < 0.0001). The Portex Soft Seal was not different above the larynx but was significantly statistically inferior at (P < 0.04) and below the larynx (P < 0.006) and inferior overall (P < 0.007). Boss Systems single-use laryngeal mask was as effective as the cLMA.
  
  
  CONCLUSIONS
  In this trial, PVC single-use laryngeal masks were inferior to the silicone cLMA and Boss Systems laryngeal masks for flexible bronchoscopy in children.
authors: Department of Paediatric Anaesthesia, Starship Children's Health, Auckland, New Zealand. pbaker@adhb.govt.nz
authors: Paul A
authors: PA
authors: Baker
authors: Katharine E J
authors: KE
authors: Brunette
authors: Catherine A
authors: CA
authors: Byrnes
authors: John M D
authors: JM
authors: Thompson
mesh_terms: D000768:Anesthesia, General; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005931:Glottis / Q000293:injuries / Q000502:physiology; D006801:Humans; D017214:Laryngeal Masks; D008153:Lubrication; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D016896:Treatment Outcome