A comparison of the ProSeal laryngeal mask and the laryngeal tube in spontaneously breathing anesthetized patients.

Abstract

In this multicenter, randomized study, we compared ease of insertion, postinsertion hemodynamic repercussion, quality of ventilation, and the capacity to achieve a "hands-free" anesthesia delivery between two new devices: the ProSeal laryngeal mask airway (PLMA) and the Laryngeal Tube (LT). The incidence of postoperative laryngopharyngeal discomfort was examined after short surgical interventions in spontaneously breathing patients. After induction with fentanyl and propofol, the respective airways were inserted into 70 adult ASA physical status I and II patients (35 patients in each group). First-attempt insertion success rates were more frequent for the PLMA (77% versus 51%; P < 0.05), but success rates were similar (100% versus 97%) after 3 attempts. The anesthesiologists considered that insertion of the PLMA was easier (P < 0.001). Expired tidal volume was larger with the PLMA (404.9 versus 328.4 mL; P < 0.005) and the ability to achieve hands-free ventilation was more frequent with the PLMA (32 versus 21 cases; P < 0.004). Positional maneuvers with the LT to correct ventilation deficiencies were not always completely effective (5 of 13). There were no differences in the incidence of intolerance, sore throat, dysphagia, and/or dysphonia between the two devices. We conclude that the PLMA showed greater ease of insertion and reliability than the LT for use in nonparalyzed anesthetized patients.