Abstract
BackgroundThe Supreme™ and ProSeal™ laryngeal mask airways (LMAs) are widely used in paediatric anaesthesia; however, LMA use in infants is limited because many anaesthesiologists prefer to use tracheal intubation in infants.In this study, we compared the Supreme and ProSeal LMAs in infants by measuring their performance characteristics, including insertion features, ventilation parameters, induced changes in haemodynamics and rates of postoperative complications.MethodsInfants of ASA physical status I scheduled for elective, minor, lower abdominal surgery were divided into two groups: the Supreme LMA group and the ProSeal LMA group. Times and ease of LMA insertion were noted. The percentages of tidal volume leakage as well as peak, mean and leakage pressures for all infants were measured. Heart rate (HR), oxygen saturation (SpO2) and end tidal carbon dioxide (EtCO2) values were recorded before and after LMA insertion and before and after extubation. After extubation, complications and adverse effects were noted.ResultsDemographic and surgical data were similar between the two groups. LMA insertion times were shorter for the ProSeal group than for the Supreme group (P < 0.002). The mean HR value for the ProSeal group was lower than for the Supreme group (P < 0.011). Both the peak pressure and the leakage percentage for the ProSeal group were statistically lower than for the Supreme group. The leakage pressure for the ProSeal group was statistically higher than for the Supreme group (P < 0.001).ConclusionsThe ProSeal LMA is superior to the Supreme LMA for use in infants due to the ease of insertion, high oropharyngeal leakage pressure and fewer induced changes in haemodynamics.Trial registrationClinicalTrial.gov, NCT03251105, retrospectively registered on 15 Aug 2017.
Highlights
The SupremeTM and ProSealTM laryngeal mask airways (LMAs) are widely used in paediatric anaesthesia; Laryngeal mask airway (LMA) use in infants is limited because many anaesthesiologists prefer to use tracheal intubation in infants
In the current paediatric literature, different LMA models have been evaluated; these studies were performed on a wide range of children, from infants to 18-year-olds [9, 10]
It has been difficult to evaluate the results of these studies for LMA use in infants alone
Summary
The SupremeTM and ProSealTM laryngeal mask airways (LMAs) are widely used in paediatric anaesthesia; LMA use in infants is limited because many anaesthesiologists prefer to use tracheal intubation in infants. The use of laryngeal mask airways (LMAs) for modern paediatric anaesthesia has gained popularity. The use of LMAs decreases complications after anaesthesia because neuromuscular blockade is not required [1]; in infants younger than 1 year of age, LMA insertion is not accomplished due to the developing airway anatomy and fragility of the oesophageal mucosa. In the current paediatric literature, different LMA models have been evaluated; these studies were performed on a wide range of children, from infants to 18-year-olds [9, 10]. A gastric access canal has been incorporated into the second-generation devices; this gastric access canal allows for gastric venting
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