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LETTERS TO EDITOR |
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Year : 2019 | Volume
: 63
| Issue : 7 | Page : 596-597 |
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Formula to memorise LMA ProSeal™ intracuff volume
Abhijeet Anand, Anjuman Chander, Reecha Panghal, Tanvi Khera
Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India
Date of Web Publication | 12-Jul-2019 |
Correspondence Address: Dr. Abhijeet Anand Room No. 213, Doctor's Hostel, Gate 6, GMCH, Sector 32 B, Chandigarh - 160 030 India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ija.IJA_124_19
How to cite this article: Anand A, Chander A, Panghal R, Khera T. Formula to memorise LMA ProSeal™ intracuff volume. Indian J Anaesth 2019;63:596-7 |
Sir,
Supraglottic airway devices have increased the armamentarium of safe airway management resources of anaesthesiologists. The list of these devices is still increasing, but LMA ProSeal™ airway holds its distinct and respectable place in the list. LMA ProSeal ™ belongs to the class of cuffed perilaryngeal sealer with directional sealing supraglottic airway devices. The uniqueness and benefits of directional sealing are best achieved when the cuff is filled with volume of air recommended by the manufacturer.
The comparably shorter learning curve of placement of LMA ProSeal™ airway as compared to endotracheal intubation makes it an attractive airway device to master not only by novice anaesthesia trainee but also by other healthcare professionals including paramedics who are trained in airway management, novice Certified Registered Nurse Anaesthetists (CRNA) or Physician Assistants (Anaesthesia) PAAs in the United Kingdom or Nurse Anaesthetists in Europe. These advantages of LMA ProSeal™ airway come with few basic prerequisites, and among them filling with correct cuff air volume is very crucial. The novice trainee finds it difficult to memorise how much air is to be filled in an LMA ProSeal™ airway of a particular size.
We have proposed an easy formula to remember the “recommended volume of air” to be filled in a particular sized LMA ProSeal™ airway:
Volume of air (in mL) = [(size of LMA ProSeal™) - 1] × 10
This formula has one exception that it does not give the volume of air to be filled in Size 1 and 1.5 of LMA ProSeal™. For these sizes, used in the paediatric population, Ho et al.[1] have given a formula for the volume of air to be filled as volume of air (in mL) = 5 × LMA size.
In the era of pressure monitored cuff inflation of all airway devices, this formula may appear not to be contemporary and apt. But in developing countries, not all centres have cuff pressure monitoring devices. So the manufacturer recommended volume of air becomes important to get standardised initial seal from LMA ProSeal™. This formula provides accurate cuff inflation volume as per manufacturer's recommendation and hence helps in getting standard initial cuff seal. This formula is no alternative to pressure manometer adjusted cuff inflation, yet this formula will aid the novice trainee in the field of anaesthesiology to use LMA ProSeal™ more confidently and safely.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References | |  |
1. | Ho AM, Karmakar MK, Dion PW. Choosing the correct laryngeal mask airway sizes and cuff inflation volumes in pediatric patients. J Emerg Med 2008;35:299-300. |
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