The ProSeal laryngeal mask: results of a descriptive trial with experience of 300 cases

Abstract

The ProSeal laryngeal mask airway (PLMA) is a new laryngeal mask device with a modified cuff and a drainage tube. We assessed the PLMA in 300 anaesthetized adults either paralysed or breathing spontaneously. We assessed insertion characteristics, airway seal pressures, haemodynamic response to insertion, ease of gastric tube placement, gastric insufflation, and postoperative sore throat. Insertion was successful in 294 patients (98%) and graded as easy in 274 patients (91%). We found no difference in ease of insertion or success rate with either the introducer or the finger insertion method, or in paralysed or non-paralysed patients. Mean airway seal pressure was 29 cm H2O, and 59 patients (20%) had seal pressures greater than 40 cm H2O. No gastric insufflation was detected. Gastric tube placement was successful in 290 of 294 patients (98.6%). There was no cardiovascular response to insertion, with a small reduction in heart rate 5 min after insertion and significant decreases in mean arterial pressure at 1 and 5 min after insertion. Sore throat was noted in 23% patients after operation and in 16% of patients after 24 h, with 90% of the sore throats described as mild. The PLMA is a reliable airway management device that can give an effective glottic seal in paralysed and non-paralysed patients. The device allows the easy passage of a gastric tube, causes a minimal haemodynamic response to insertion, and an acceptable incidence of sore throat.