A clinical evaluation of four disposable laryngeal masks in adult patients

Abstract

Study Objective To compare the clinical use of four disposable laryngeal masks (DLMs): the Ambu laryngeal mask [Ambu LM], Solus, Laryngeal Mask Airway (LMA) Unique, and Soft Seal. Design Prospective, randomized study. Setting Operating room and recovery area of a university-affiliated ambulatory surgery unit. Patients 200 adult ASA physical status I, II, and III patients, scheduled for ambulatory procedures. Interventions Patients underwent insertion of the DLM by nonexperienced residents. Measurements The time and number of attempts needed for insertion, quality of ventilation, airway sealing pressure at 60 cmH 2O of intracuff pressure, and complications were all evaluated. Main results Ease of insertion was greater ( P = 0.03) and first attempt success rate was higher with the Ambu LM (78%) and LMA Unique (80%). The Solus most often needed three attempts to be placed (12 cases); the Ambu LM needed three similar attempts in two cases; the LMA Unique in 4 cases; and the Soft Seal in 5 cases ( P = 0.018). The LMA Unique achieved the highest rate of optimal ventilation (46/49 cases) of the 4 groups. Airway sealing pressure was significantly higher with the Soft Seal (27.3 ± 5 mmHg), compared to the Ambu LM (23.7 ± 5 mmHg), the Solus (20.9 ± 4 mmHg), and the LMA Unique (22.1 ± 6 mmHg) ( P < 0.001). Blood staining of the DLM on removal was most frequent with the Soft Seal (38%). Conclusions The Ambu LM and LMA Unique DLMs appear to be easier to insert by inexperienced residents and are less traumatic for the patient. The Soft Seal achieves a higher airway seal than other devices, but it causes more mucosal trauma. The Solus had the highest insertion failure rate of the 4 groups.