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- Title
Comparison of the size 3 and size 4 ProSeal™ laryngeal mask airway in anesthetized, non-paralyzed women: a randomized controlled trial.
- Authors
Kim, Mi-Hyun; Hwang, Jung-Won; Kim, Eun-Sung; Han, Sung-Hee; Jeon, Young-Tae; Lee, Sun-Mi
- Abstract
Purpose: Based on experimental results, various authors have advocated a size 4 ProSeal™ laryngeal mask airway (PLMA) in preference to a size 3 PLMA for women given a neuromuscular blocking agent because the larger size provided a better airway seal. However, spontaneously breathing patients may be ventilated adequately with a lower seal pressure than that needed for mechanical ventilation. Therefore, a smaller size might be preferable as its reduced bulk possibly induces less mucosal damage in non-paralyzed patients. Methods: A total of 152 females undergoing general anesthesia for short outpatient gynecological surgeries were randomly allocated in equal numbers to insertion of a size 3 or 4 PLMA. The insertion time, success rate, seal pressure, hemodynamic variables, and complications, such as blood staining and sore throat, were evaluated. Results: The incidence of blood staining was lower with the size 3 PLMA compared to the size 4 PLMA (18 vs. 36 %; P = 0.028). Compared with the size 3 LMA, the size 4 PLMA resulted in higher fluctuations in both blood pressure ( P = 0.003) and heart rate ( P = 0.01). The insertion time was shorter with the size 3 PLMA (9 vs. 16 s; P < 0.001). The airway seal pressure with the size 3 PLMA, although lower than that of the size 4 PLMA (23 vs. 28 cmHO; P = 0.001), was sufficient for spontaneous ventilation. Conclusions: Due to the reduced incidence of mucosal injury and greater hemodynamic stability, the size 3 PLMA may be preferable to the size 4 PLMA for non-paralyzed females.
- Subjects
LARYNGEAL masks; AIRWAY (Anatomy); NEUROMUSCULAR blocking agents; GENERAL anesthesia; ANESTHESIOLOGY
- Publication
Journal of Anesthesia, 2015, Vol 29, Issue 2, p256
- ISSN
0913-8668
- Publication type
Article
- DOI
10.1007/s00540-014-1916-5