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Comparison of the modified Airway Management Device with the Proseal laryngeal mask airway in patients undergoing gynaecological procedures

Published online by Cambridge University Press:  23 December 2005

L. L. Pay  and
Y. Lim
L. L. Pay
Affiliation:
KK Women's and Children's Hospital, Department of Women's Anaesthesia, Singapore
Y. Lim
Affiliation:
KK Women's and Children's Hospital, Department of Women's Anaesthesia, Singapore
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Summary

Background and objective: The modified Airway Management Device (AMD) and the Proseal laryngeal mask airway (PLMA) are both supraglottic airway devices designed to maintain airway patency and allow ventilation during anaesthesia. In this prospective, randomized trial, we compared the two devices in patients undergoing major gynaecological procedures. Methods: Eighty-two patients undergoing elective gynaecological surgery were randomized to two groups. Group A (n = 41) had the AMD and Group P (n = 41) the PLMA inserted after induction of anaesthesia. We compared the success of airway placement, time to achieve an airway, oropharyngeal leak pressure and complications associated during anaesthesia. Results: There were no differences in patient characteristic profile for both groups. First time insertion success rates were significantly higher in Group P than in Group A (100% vs. 83%, P < 0.012). Time taken to achieve airway was also significantly shorter in Group P than in Group A (mean 21.9 ± 7.8 s vs. 40.2 ± 48.0 s, P < 0.001). The oropharyngeal leak pressure was significantly higher for Group P than Group A (mean 31.2 ± 5.7 cmH2O vs. 24.2 ± 8.3 cmH2O, P < 0.001). Ten patients in Group A had transient loss of airway during anaesthesia and needed manipulation of the airway device and four patients needed to have the airway switched to PLMA for the rest of the procedure. Conclusions: The modified AMD has a significant lower first time successful placement rate, required a longer insertion time and has a lower oropharyngeal leak pressure than the PLMA. It also demonstrated an increased loss of airway during anaesthesia. The modified AMD needs further evaluation on its efficacy and safety before its further use can be recommended.

Keywords

LARYNGEAL MASKSRESPIRATIONANAESTHESIA GENERAL, equipment, airway management devices
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 1 , January 2006 , pp. 71 - 75
Copyright
© 2006 European Society of Anaesthesiology

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