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LETTER TO EDITOR
Year : 2010  |  Volume : 54  |  Issue : 5  |  Page : 481 Table of Contents     

Damaged Proseal TM LMA inflation line can be repaired


Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry - 605 006, India

Date of Web Publication9-Oct-2010

Correspondence Address:
Pankaj Kundra
DII/21, JIPMER Campus, Pondicherry - 605 006
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.71029

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How to cite this article:
Kundra P, Nisha B. Damaged Proseal TM LMA inflation line can be repaired. Indian J Anaesth 2010;54:481

How to cite this URL:
Kundra P, Nisha B. Damaged Proseal TM LMA inflation line can be repaired. Indian J Anaesth [serial online] 2010 [cited 2020 Apr 1];54:481. Available from: http://www.ijaweb.org/text.asp?2010/54/5/481/71029

Sir,

Laryngeal mask airway (LMA) Proseal TM is available as a reusable device made up of medical grade silicone that can be autoclaved 40 times. [1],[2] Its life span depends on the number, temperature and duration of the autoclave cycles. However, these devices can also be damaged during clinical use from biting, [3] surgical instruments, accidental introduction of fluid into the cuff [4] and during cleaning and disinfection. [2]

A size 3 LMA Proseal TM was discovered with a damaged inflation line during routine morning inspection before use. The damage was incurred as the inflation line was caught between the lid and the metal box during storage. The cuff and shaft of the LMA were intact, as confirmed by close visual inspection and by placing it under water after full inflation. Because it was an isolated damage to the inflation line, the possibilities of repairing the inflation line were explored to put it back to use without jeopardizing patient safety. A 4-cm cut-segment of the inflation line of a 9-mm (internal diameter) polyvinyl chloride (PVC), disposable, cuffed endotracheal tube was used as an internal stent to oppose the transected ends of the inflation line of the Proseal TM LMA. The internal diameter of the Proseal TM LMA inflation line (1.5 mm) provided a snug fit on the cut segment of the endotracheal tube pilot balloon inflation line with an external diameter of 1.7 mm without the use of an adhesive [Figure 1]. The Proseal TM LMA was autoclaved and its integrity was confirmed to ensure there was no leak before putting it to clinical use. Since repair, the Proseal TM LMA has already been put to use 12 times, and it has withstood autoclaving satisfactorily.
Figure 1: Steps of repair of the inflation line

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Given the expensive capital cost of reusable Proseal TM LMA (Rs. 12,000 per piece approximately), a repair can be attempted if an isolated damage to the inflation line is discovered. However, care must be taken to ascertain that other components are intact and a preuse safety test should be performed before using them on patients.

 
   References Top

1.Doneley S, Brimacombe J, Keller C, von Goedecke A. The proseal TM has a shorter life span than the classicTM laryngeal mask airway. Anesth Analg 2005;100:590-3.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]  
2.Wong DT, McGuire GP. Fractured LMA. Can J Anesth 2000;47:716.  Back to cited text no. 2  [PUBMED]    
3.Woods K. Pilot tube of the laryngeal mask airway. Anaesthesia 2007;49:450-1.  Back to cited text no. 3      
4.Jolly DT, Escalona A, Clarke D. Destruction of the LMA Proseal TM with the red plug during steam autoclaving. Can J Anesth 2004;51:193.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]  


    Figures

  [Figure 1]


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