title: [About laryngeal mask: is the lowest price material the better cost-efficacy choice?].
abstract: OBJECTIVE
  The main goal of this study was to achieve a medico-economic comparison between four disposable laryngeal masks (LM) (LMA-Unique™, Ambu AuraOnce™, I-Gel™ and LMA-Suprême™).
  
  
  METHODS
  A prospective, randomized, monocentre study.
  
  
  METHODS
  In a center, using routinely LMA-Unique masks, scheduled breast surgery patients were allocated into four groups according to the LM model. After the induction, the modalities of use were collected, as well as the intraoperative events that required additional anesthetic equipment. The real cost of each model was calculated (cost of the mask+extra cost related to complications). Using the LMA-Unique as a reference, we performed a cost-efficacy analysis. We realized a cost-efficiency analysis putting in parallel the impact on the cost and the incidence of the events.
  
  
  RESULTS
  A total of 178 patients were included. According to the cost-efficacy analysis, the dominant model was the Ambu AuraOnce™ (Δreal cost: -34.2%, Δevents: -30.6%). The LMA-Unique™ was dominated because of a high morbidity rate. The I-Gel™ and LMA-Suprême™ models were more efficient but more expensive (Δreal cost: +16% and +22.5% respectively). To compensate for additional costs, it would be necessary to apply a price reduction of at least 50%.
  
  
  CONCLUSIONS
  Despite their better efficiency and safety, the latest generation laryngeal masks are still expensive in spite of a low rate of complication. These results do not take into account very rare and severe complications not met in this study in the limited size; then the economic and medical impact can influence the choice beyond the simple analysis cost-efficiency.
authors.affiliation: Service d'anesthésie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France. Electronic address: gregoire.weil@gustaveroussy.fr.
authors.forename: G
authors.initials: G
authors.lastname: Weil
authors.affiliation: Service d'anesthésie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
authors.forename: J
authors.initials: J
authors.lastname: Matysiak
authors.affiliation: Service d'anesthésie, hôpital Armand-Trousseau, 75012 Paris, France.
authors.forename: M-L
authors.initials: ML
authors.lastname: Guye
authors.affiliation: Service d'anesthésie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
authors.forename: A
authors.initials: A
authors.lastname: Eghiaian
authors.affiliation: Service d'anesthésie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Bourgain
mesh_terms: D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation / Q000295:instrumentation; D003362:Cost-Benefit Analysis; D004209:Disposable Equipment / Q000191:economics*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D017214:Laryngeal Masks / Q000009:adverse effects / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies
keywords: Airway; Cost-efficacy analysis; Laryngeal mask; Masque laryngé; Medico-economics; Voies aériennes; Étude coût-efficacité; Étude médico-économique