Intracuff pressures in ProSeal and Supreme airways

Abstract

AnaesthesiaVolume 69, Issue 2 p. 183-183 CorrespondenceFree Access Intracuff pressures in ProSeal and Supreme airways A. Philip, A. Philip [email protected] Leicester Royal Infirmary, Leicester, UKSearch for more papers by this authorV. Kaushik, V. Kaushik Leicester Royal Infirmary, Leicester, UKSearch for more papers by this authorM. Mushambi, M. Mushambi Leicester Royal Infirmary, Leicester, UKSearch for more papers by this author A. Philip, A. Philip [email protected] Leicester Royal Infirmary, Leicester, UKSearch for more papers by this authorV. Kaushik, V. Kaushik Leicester Royal Infirmary, Leicester, UKSearch for more papers by this authorM. Mushambi, M. Mushambi Leicester Royal Infirmary, Leicester, UKSearch for more papers by this author First published: 20 January 2014 https://doi.org/10.1111/anae.12569Citations: 1 No external funding and no competing interests declared. Previously posted on the Anaesthesia correspondence website: www.anaesthesiacorrespondence.com. AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat We read with interest the article by Anand et al. 1 comparing intracuff pressures between the ProSeal® and Supreme® laryngeal mask airways (LMAs) and should like the authors to clarify some issues that are not clear in their article: Did the authors standardise tidal volumes and peak airway pressures for all their patients? The authors mention that the initial intracuff readings were 60 cmH20 in both groups. Were the cuffs intentionally inflated to that value? If so, the authors chose to inflate the cuffs to the upper limit of the manufacturers' recommendations, which is usually unnecessary since an adequate seal can be achieved at lower cuff pressures. Silicone cuff-based ProSeal LMAs are re-used after sterilisation. Did the authors factor this into their standardisation, i.e. a ProSeal LMA that has been sterilised 30 times will presumably allow more diffusion of nitrous oxide than one that has been sterilised, say, 10 times or less? In Zhang et al.'s study 2, referred to by Anand and colleagues in their study, oropharyngeal leak pressure was determined by closing the expiratory valve at a fixed gas flow of 3 l.min−1 and noting the pressure in the circuit at which an audible leak is heard over the mouth. It is not clear how Anand et al. checked the oropharyngeal leak pressure; was it using a similar method? Anand et al. recommend that cuff pressure should be monitored when ProSeal LMAs are used during general anaesthesia involving nitrous oxide. Recommendations to monitor cuff pressures in LMAs should apply to all LMAs, and not just to ProSeal LMAs. References 1Anand LK, Singh M, Kapoor D, Goel N. Intracuff pressure comparison between ProSeal® and Supreme® laryngeal mask airways. Anaesthesia 2013; 68: 1202– 3. 2Zhang L, Seet E, Mehta V, et al. Oropharyngeal leak pressure with the laryngeal mask airway supreme™ at different intracuff pressures: a randomized controlled trial. Canadian Journal of Anesthesia 2011; 58: 624– 9. Citing Literature Volume69, Issue2February 2014Pages 183-183 ReferencesRelatedInformation