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CLINICAL INVESTIGATION
Year : 2008  |  Volume : 52  |  Issue : 1  |  Page : 44

Comparison of LMA-ProSealTM with LMA ClassicTM in Anaesthetised Paralysed Children


1 Senior Resident, Department of Anaesthesiology, Pain & Perioperative Medicine, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi., India
2 Senior Consultant, Department of Anaesthesiology, Pain & Perioperative Medicine, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi., India
3 Senior Consultant & Chairperson, Department of Anaesthesiology, Pain & Perioperative Medicine, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi., India
4 Emeritus Consultant, Department of Anaesthesiology, Pain & Perioperative Medicine, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi., India

Correspondence Address:
Pravesh Kanthed
Senior Resident, Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi - 110 060.
India
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Source of Support: None, Conflict of Interest: None


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The classic laryngeal mask airway (cLMA), though popular in anaesthesia practice provides low oropharyngeal seal pressure and there are concerns with its use during positive pressure ventilation for fear of gastric distension with subsequent gastric regurgitation and pulmonary aspiration. The ProSeal laryngeal mask airway (PLMA) is a modified LMA with a larger, wedge shaped cuff and a drain tube. This modification improves the seal around glottis when compared to a cLMA and its drain tube prevents gastric distension and offers protection against aspiration when properly placed. We compared PLMA and cLMA in 100 anaesthetized, paralysed children with 50 patients in each group with respect to ease of insertion, oropharyngeal seal pressure and pharyngolaryngeal morbidity. Gastric tube insertion was also assessed for the PLMA. The ease of insertion and the number of attempts at insertion were found to be comparable in the two groups while the oropharyngeal seal pressure was significantly higher in the PLMA group (P < 0.001). The pharyngolaryngeal morbidity was comparable in both the groups. There was no incidence of regurgitation or aspiration in either group. The PLMA offered high reliability of gastric tube placement and significantly increased oropharyngeal seal pressure over the cLMA. This might have an important implication for use of this device for positive pressure ventilation in children.


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