A preliminary assessment of the LMA protector™ in non-paralysed patients

Ban Leong Sng, Farida Binte Ithnin, Deepak Mathur, Eileen Lew, Nian-Lin Reena Han, Alex Tiong-Heng Sia, Ban Leong Sng, Farida Binte Ithnin, Deepak Mathur, Eileen Lew, Nian-Lin Reena Han, Alex Tiong-Heng Sia

Abstract

Background: The LMA Protector™ is the latest CE marked single use supraglottic airway device. This airway device provides access and functional separation of the respiratory and digestive tracts. There are two ports (male, female ports) to provide suction in the laryngeal region and insertion of the gastric tube. The aim of our study is to assess the ease of use, airway quality, device positioning, airway leak and complications associated with initial clinical experience in LMA Protector™ usage.

Methods: This is an initial investigation of LMA Protector™ airway device. We conducted a preliminary assessment in the anaesthetised women who underwent minor gynaecological procedures with spontaneous ventilation in order to evaluate the performance of the airway device.

Results: Insertion was successful on first and second attempts in 23 (88.5%) and 3 (11.5%) respectively. Median [IQR (range)] insertion time was 19 [17-21(14-58)] seconds. Airway leak pressure was 25.5 [23-29(21-30] cmH2O. On fibreoptic examination via the device, vocal cords were visible in all 26 patients. There were no alternative airway use or airway manipulations required during maintenance of anaesthesia. Six patients had sore throat 24 h after procedures and there was no dysphagia or hoarseness.

Conclusion: This pilot study of the LMA protector shows that the device is easily inserted with fast insertion time, providing a reliable and adequate airway seal.

Trial registration: Clinicaltrials.gov Registration NCT02531256 . Retrospectively registered on August 21, 2015.

Keywords: Airway management; Anaesthesia; Laryngeal mask.

Figures

Fig. 1
Fig. 1
The LMA Protector™ contains two separate drain channels

References

    1. Van Zundert AA, Skinner MW, Van Zundert TC, Luney SR, Pandit JJ. Value of knowing physical characteristics of the airway device before using it. Br J Anaesth. 2016;117(1):12–6. doi: 10.1093/bja/aew106.
    1. Van Zundert AA, Kumar CM, Van Zundert TC. Malpositioning of supraglottic airway devices: preventive and corrective strategies. Br J Anaesth. 2016;116(5):579–82. doi: 10.1093/bja/aew104.
    1. Verghese C, Berlet J, Kapila A, Pollard R. Clinical assessment of the single use laryngeal mask airway--the LMA-unique. Br J Anaesth. 1998;80:677–9. doi: 10.1093/bja/80.5.677.
    1. Brimacombe J, Keller C, Judd DV. Gum elastic bougie-guided insertion of the ProSeal laryngeal mask airway is superior to the digital and introducer tool techniques. Anesthesiology. 2004;100(1):25–9. doi: 10.1097/00000542-200401000-00008.
    1. Maitra S, Khanna P, Baidya DK. Comparison of laryngeal mask airway Supreme and laryngeal mask airway Pro-Seal for controlled ventilation during general anaesthesia in adult patients: systematic review with meta-analysis. Eur J Anaesthesiol. 2014;31:266–73. doi: 10.1097/01.EJA.0000435015.89651.3d.
    1. Verghese C, Ramaswamy B. LMA-Supreme--a new single-use LMA with gastric access: a report on its clinical efficacy. Br J Anaesth. 2008;101:405–10. doi: 10.1093/bja/aen174.
    1. van Zundert A, Brimacombe J. The LMA Supreme--a pilot study. Anaesthesia. 2008;63:209–10. doi: 10.1111/j.1365-2044.2007.05421.x.
    1. Joly N, Poulin LP, Tanoubi I, Drolet P, Donati F, St-Pierre P. Randomized prospective trial comparing two supraglottic airway devices: i-gel and LMA-Supreme in paralyzed patients. Can J Anaesth. 2014;61:794–800. doi: 10.1007/s12630-014-0198-6.
    1. Cook TM, Lee G, Nolan JP. The ProSeal laryngeal mask airway: a review of the literature. Can J Anaesth. 2005;52:739–60. doi: 10.1007/BF03016565.
    1. Cook TM, Gatward JJ, Handel J, Hardy R, Thompson C, Srivastava R, Clarke PA. Evaluation of the LMA Supreme in 100 non-paralysed patients. Anaesthesia. 2009;64:555–62. doi: 10.1111/j.1365-2044.2008.05824.x.
    1. Cook TM, Nolan JP, Verghese C, Strube PJ, Lees M, Millar JM, Baskett PJ. Randomized crossover comparison of the proseal with the classic laryngeal mask airway in unparalysed anaesthetized patients. Br J Anaesth. 2002;88:527–33. doi: 10.1093/bja/88.4.527.
    1. Gatward JJ, Cook TM, Seller C, Handel J, Simpson T, Vanek V, Kelly F. Evaluation of the size 4 i-gel airway in one hundred non-paralysed patients. Anaesthesia. 2008;63:1124–30. doi: 10.1111/j.1365-2044.2008.05561.x.
    1. Brimacombe J, Keller C. The ProSeal laryngeal mask airway: A randomized, crossover study with the standard laryngeal mask airway in paralyzed, anesthetized patients. Anesthesiology. 2000;93:104–9. doi: 10.1097/00000542-200007000-00019.
    1. Brimacombe J, Keller C, Fullekrug B, Agrò F, Rosenblatt W, Dierdorf SF, Garcia de Lucas E, Capdevilla X, Brimacombe N. A multicenter study comparing the ProSeal and Classic laryngeal mask airway in anesthetized, nonparalyzed patients. Anesthesiology. 2002;96:289–95. doi: 10.1097/00000542-200202000-00011.
    1. Braun U, Zerbst M, Füllekrug B, Gentzel I, Hempel V, Leier M, Peters T, Hobbensiefken G, Klein U, Heuser D, Weyland A, Rey D, Weirich C, Krier C. A comparison of the Proseal laryngeal mask to the standard laryngeal mask on anesthesized, non-relaxed patients. Anasthesiol Intensivmed Notfallmed Schmerzther. 2002;37:727–33. doi: 10.1055/s-2002-35911.
    1. Mihai R, Knottenbelt G, Cook TM. Evaluation of the revised laryngeal tube suction: the laryngeal tube suction II in 100 patients. Br J Anaesth. 2007;99:734–9. doi: 10.1093/bja/aem260.
    1. Keller C, Brimacombe J, Kleinsasser A, Loeckinger A. Does the ProSeal laryngeal mask airway prevent aspiration of regurgitated fluid? Anesth Analg. 2000;91:1017–20. doi: 10.1097/00000539-200010000-00046.
    1. Samsoon GL, Young JR. Difficult tracheal intubation: a retrospective study. Anaesthesia. 1987;42(5):487–90. doi: 10.1111/j.1365-2044.1987.tb04039.x.
    1. Pandit JJ, Popat MT, Cook TM, Wilkes AR, Groom P, Cooke H, Kapila A, O'Sullivan E. The Difficult Airway Society 'ADEPT' guidance on selecting airway devices: the basis of a strategy for equipment evaluation. Anaesthesia. 2011;66:726–37. doi: 10.1111/j.1365-2044.2011.06787.x.
    1. Pandit JJ. If it hasn't failed, does it work? On 'the worst we can expect' from observational trial results, with reference to airway management devices. Anaesthesia. 2012;67:578–83. doi: 10.1111/j.1365-2044.2012.07155.x.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren