title: [Experience with the proseal laryngeal mask in ventriculoperitoneal shunting].
abstract: OBJECTIVE
  To describe the use, utility, safety, and effectiveness of the Proseal laryngeal mask for airway management in patients undergoing ventriculoperitonea shunting.
  
  
  METHODS
  We retrospectively reviewed the records of all patients in whom the Proseal laryngeal mask was used during ventriculoperitoneal shunting between January 2006 and October 2009. Patient demographic characteristics, airway assessments, type of anesthesia, quality of ventilation, and perioperative complications were recorded.
  
  
  RESULTS
  Of the 43 patients included, 8 (18.6%) had at least 1 difficult airway criterion. We were able to insert the Proseal laryngeal mask in all patients. Ventilation was optimal in 39 (91%) patients, with maintenance of end-expiratory carbon dioxide pressures between 35 and 40 mm Hg and airway pressures above 25 cm H2O throughout the procedures. Air leaks developed in 3 cases (7%) when the patient was placed in a lateral-cervical position for surgery; these patients required orotracheal intubation before surgery could begin. Mean duration of surgery was 53 minutes. Awakening occurred without incident in all cases.
  
  
  CONCLUSIONS
  The Proseal laryngeal mask is useful for airway management in patients undergoing ventriculoperitoneal shunting. Due to the forced position of the neck, however, it may be necessary to reposition the mask or even proceed to orotracheal intubation in some cases. As is the case for other advanced uses, experience with the device is necessary. Material for managing a difficult airway should be on hand.
authors.affiliation: Servicio de Anestesiologia, Reanimación y Terapéutica del Dolor, Hospital Clinicá de Barcelona.
authors.forename: P
authors.initials: P
authors.lastname: Hurtado
authors.forename: R
authors.initials: R
authors.lastname: Valero
authors.forename: J
authors.initials: J
authors.lastname: Tercero
authors.forename: E
authors.initials: E
authors.lastname: Carrero
authors.forename: N
authors.initials: N
authors.lastname: de Riva
authors.forename: A M
authors.initials: AM
authors.lastname: López
authors.forename: J
authors.initials: J
authors.lastname: Enseñat
authors.forename: M
authors.initials: M
authors.lastname: Ubré
authors.forename: D
authors.initials: D
authors.lastname: Lushchenkov
authors.forename: N
authors.initials: N
authors.lastname: Fàbregas
mesh_terms: D058109:Airway Management; D004867:Equipment Design; D005260:Female; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017287:Ventriculoperitoneal Shunt