ProSeal Laryngeal Mask Airway Research Articles

Dexmedetomidine with propofol versus fentanyl with propofol for insertion of Proseal laryngeal mask airway: A randomized, double-blinded clinical trial

Background and Aims:Successful insertion of the proseal laryngeal mask airway (PLMA) requires much greater doses of propofol as compared to classic laryngeal mask (CLMA). Dexmedetomidine and fentanyl are equally effective adjuvants for CLMA insertion. We designed this study to compare the efficacy of these two drugs as sole adjuvant in PLMA insertion.Material and Methods:Seventy four American Society of Anesthesiologists (ASA) I and II patients were randomly allocated to receive either dexmedetomidine 1 μg/kg [Group PD] or fentanyl 1 μg/kg [Group PF]. Study drugs were diluted in 10 ml NS and administered over 10 min prior to induction of anesthesia with 2.5 mg/kg propofol. PLMA insertion condition was measured according to the Muzi scoring system. Score ≤2 was considered optimal for PLMA insertion. Patient's cardio-respiratory parameters, emergence time, and postoperative pain were also recorded.Results:In our study 83.8% patients in the group PF and 91.9% in the group PD achieved optimal insertion condition (not significant). Hemodynamic stability was maintained in both the groups but the incidence of apnea was significantly higher in the PF group (P = 0.011). We also observed that emergence time was prolonged but postoperative pain scores were significantly lower in the PD group (P < 0.001).Conclusion:We conclude that both dexmedetomidine and fentanyl in a dose of 1 μg/kg when used before induction with propofol provide comparable conditions for successful PLMA insertion. Dexmedetomidine has additional advantage of preserving spontaneous respiration and providing better analgesia.

Proseal Laryngeal Mask Airway: An Alternative to Endotracheal Intubation in Adult Patients for Surgical Procedures Under General Anaesthesia

Proseal Laryngeal Mask Airway: An Alternative to Endotracheal Intubation in Adult Patients for Surgical Procedures Under General Anaesthesia

Comparison of I-gel versus proseal laryngeal mask airway (PLMA) for elective surgical elective surgical procedures

Comparison of I-gel versus proseal laryngeal mask airway (PLMA) for elective surgical elective surgical procedures

A Comparative Evaluation of Respiratory Mechanics with I-Gel or ProSeal LMA as Airway Device in Laparoscopic Surgeries

A Comparative Evaluation of Respiratory Mechanics with I-Gel or ProSeal LMA as Airway Device in Laparoscopic Surgeries

A Prospective Randomized Comparative Study between Baska Mask, Proseal LMA and I Gel during Positive Pressure Ventilation in Laparoscopic Cholecystectomy

A Prospective Randomized Comparative Study between Baska Mask, Proseal LMA and I Gel during Positive Pressure Ventilation in Laparoscopic Cholecystectomy

Comparison of Laryngeal Mask Airway Proseal and Supreme in Patients Posted for Elective Surgeries Under General Anaesthesia: A Randomised Clinical Trial

Comparison of Laryngeal Mask Airway Proseal and Supreme in Patients Posted for Elective Surgeries Under General Anaesthesia: A Randomised Clinical Trial

The Evaluation of Proseal Laryngeal Mask Airway as an Alternative to Endotracheal Intubation in Patients Undergoing Laparoscopic Cholecystectomy

The Evaluation of Proseal Laryngeal Mask Airway as an Alternative to Endotracheal Intubation in Patients Undergoing Laparoscopic Cholecystectomy

Severed inflation line of ProSeal Laryngeal Mask Airway: repaired using tissue dilator of central venous catheter

Severed inflation line of ProSeal Laryngeal Mask Airway: repaired using tissue dilator of central venous catheter

The tooth of the matter: Diastema as the rare cause of pilot tube obstruction of Proseal LMA!

The tooth of the matter: Diastema as the rare cause of pilot tube obstruction of Proseal LMA!

Comparison of the performance of LMA proseal versus I-GEL under dexmedetomidine sedation

Comparison of the performance of LMA proseal versus I-GEL under dexmedetomidine sedation

Comparison of supraglottic airway devices in laparoscopic surgeries: A network meta-analysis

Study objectiveTo review all randomized controlled trials (RCTs) on supraglottic airway devices (SADs) used in laparoscopy and compare their oropharyngeal leak pressure (OLP) and peak inspiratory pressure (PIP) before and after pneumoperitoneum, and success rate of gastric tube insertion rate. DesignSystematic review and network meta-analysis of RCTs. SettingLaparoscopic surgeries using SADs. PatientsWe searched MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar databases to detect all relevant RCTs on SADs for laparoscopic surgery published until March 2018. InterventionsUse of different SADs. MeasurementsThe primary endpoint was OLP before and after pneumoperitoneum. The secondary endpoints were PIP before and after pneumoperitoneum and gastric tube insertion success rate. Main resultsTwenty-six studies involving 2142 patients with eight different SADs were evaluated. According to surface under the cumulative ranking curve value, the OLP before pneumoperitoneum was the highest in Ambu AuraGain (95.7%), followed by Laryngeal Mask Airway ProSeal (77.3%) and Streamlined Liner of the Pharynx Airway (75.6%); after pneumoperitoneum, the pressure was the highest in i-gel (95.8%). PIP was the highest in Ambu AuraGain (80.9%) before pneumoperitoneum and i-gel (69.4%) after pneumoperitoneum. ConclusionAlthough all SADs available were not evaluated, and further studies are needed to establish our results, OLP was the highest in Ambu AuraGain before pneumoperitoneum and i-gel after pneumoperitoneum.

Comparison of the clinical performance of I-gel, proseal LMA and classic LMA in geriatric patients: Preliminary results

Comparison of the clinical performance of I-gel, proseal LMA and classic LMA in geriatric patients: Preliminary results

Clinical Evaluation of the Cricoid Pressure Effect on Bag Mask Ventilation, ProSeal Laryngeal Mask Airway Placement and Ventilation.

Supraglottic airway devices can be life-saving in the 'cannot intubate, cannot oxygenate' situation. The cricoid pressure (CP) is considered critical in the prevention of aspiration. The aim of this self-controlled study was to evaluate the effect of CP on the bag mask ventilation (BMV), and the placement of and the ventilation through, the ProSeal laryngeal mask airway (LMA). In 60 adult patients undergoing elective surgery, after induction of anaesthesia, the effect of bimanual CP (≈30N) on BMV, ventilation through the ProSeal LMA, its anatomic position and airway seal pressures were evaluated. CP was released, the ProSeal LMA was reseated (appropriate position), the above assessments were repeated, and the effect of CP on the tidal volume (TV) and peak inspiratory pressure (PIP) was noted. Out of 60 patients, the bag mask ventilation with CP was adequate in 25 (41.7%) patients compared to 59 (98.3%) patients without CP; p<0.001. The ventilation via the ProSeal LMA with CP was excellent, adequate and impossible in 0.0% (0), 49.2% (29) and 50.8% (30) patients, respectively, compared to 93.3% (56), 6.7% (4), 0% (0) patients, respectively, without CP; p<0.001. Releasing CP and advancing the ProSeal LMA to its appropriate position significantly improved the ventilation and anatomic position scores; both p<0.001. Airway seal pressures improved significantly without CP compared to with CP; p<0.001). With the ProSeal LMA in a proper position, the CP application resulted in a significant decrease in the mean expired TV (489.14±91.62 vs. 355.08±104.42 mL) with an increase in PIP (16.72±5.01 vs. 30.71±6.74 cmH2O); both p<0.001. The application of bimanual CP (≈30N) interferes with the bag mask ventilation and prevents both the correct placement and ventilation via the ProSeal LMA in adult patients.

Endotracheal Tube and Proseal Laryngeal Mask Airway in Elderly Hypertensive Diabetic Patients Undergoing Routine Laparoscopic Surgical Procedures: A Comparison of Hemodynamic Parameters

Background: The effects of ProSeal laryngeal mask airway (PLMA) removal and tracheal extubationon cardiovascular responses were studied in elderly hypertensive diabetic patients in a randomize double-blind study.Methods: A total of 60 elderly controlled diabetic hypertensive American Society of Anesthesiologists II &amp; III patients were randomly allocated to two groups (n-30 of each) for PLMA insertion or endotracheal intubation. A standardized anesthetic sequence was used for induction and maintenance of anesthesia. The two groups were then compared for haemodynamic changes at the time of extubation/PLMA removal.Results: In PLMA group, heart rate increased during PLMA removal but remained elevated for only 3 minutes while mean arterial pressure remained elevated for only 2 minutes.The elevations of heart rate and mean arterial pressure were exaggerated in the extubation group and persisted for more than 5 minutes. No complication was observed in any patient and no difficulty was encountered in insertion of PLMA in any patient.Conclusion: Elderly hypertensive diabetic patients are at risk of exaggerated pressor response at the time of extubation. PLMA removal is associated with fewer hemodynamic changes than tracheal extubation and should be preferred wherever possible.J Bangladesh Coll Phys Surg 2018; 36(4): 153-158

Prospective randomized study comparing the standard weight-based method and a novel method based on combined width of index, middle and ring fingers for ProSeal laryngeal mask airway size selection in paediatric patients

Introduction : Appropriate size selection of ProSeal laryngeal mask airway (PLMA) is an important prerequisite for successful use of the device. Size of PLMA is often selected based on weight of patients. We aimed to determine whether combined width of patient’s index, middle and ring fingers could be used as an alternative to weight based selection of appropriate size of PLMA. Materials and methods : In this prospective randomized study, 102 patients aged 6 months to 10 years were included. Patients were allocated to one of two groups based on a randomization table and PLMA inserted according to the group allocated. In Group S, PLMA size selected according to weight based method whereas in Group N, PLMA size was selected based on 3-finger breadth of patients. We recorded insertion parameters, fiberoptic scoring of glottic visualisation, airway manipulations and postoperative complications. Results : In 68 children (66.66%) size of PLMA was same according to both methods. The kappa coefficient was 0.461 concluding moderate agreement between two methods. In the remaining 34 children (33.34%), the disagreement in sizes were with only one size, in whom the patient’s weights were borderline values. The PLMA insertion time, ease of insertion, insertion attempts, fiberoptic view of position of device were comparable in both groups. There were no significant complications in the postoperative period. Conclusion : Three finger breadth sizing method can be used as a good alternative to weight-based method for selecting appropriate size of PLMA in children.

To compare Proseal laryngeal mask airway &amp;amp; supreme laryngeal mask airway as ventilatory devices

Background: The present study was conducted to compare Proseal laryngeal mask airway (PLMA) and Supreme laryngeal mask airway (SLMA) as ventilatory devices during general anaesthesia. Materials & Methods: The present study was conducted on 30 patients of both genders undergoing elective surgery. Patients were divided into 2 groups of 15 each. Group I patients were given Proseal laryngeal mask airway and group II were given supreme laryngeal mask airway. In both groups, insertion times, number of insertion attempts, Haemodynamic response to insertion, ease of insertion of airway device and gastric tube, oropharyngeal leak pressure (OLP) and pharyngolaryngeal morbidity were assessed. Results: In group I (cm H2O), OLP1 was 34.2 and in group II was 28.4, OLP2 in group I was 34.2 and in group II was 28.5, OLP3 in group I was 34.3 and in group II was 28.6. The difference was significant (P

Pressure responses following the insertion of pro-seal laryngeal mask airway in patients with controlled hypertension: A comparison with tracheal intubation

Aims &amp; Objectives: To compare:1) Hemodynamic responses during insertion of pro-seal laryngeal mask airway (PLMA) vs endo-tracheal tubation (ETT) in hypertensive patients under control. 2) The incidence of complications.&#x0D; Methods: A total of 30 patients aged between 45-60 years of ASA grade II having history of essential hypertension under control, were on oral medication who were posted for abdominal surgeries under GA were randomly divided into two groups of 15 each (One group for PLMA insertion and other for ETT insertion). The two groups were compared for pressor responses following insertion of PLMA or ETT.&#x0D; Results: After PLMA Insertion, mean pulse increased from 67±7 to 68±5 per minute, Systolic Blood Pressure (BP) increased from 123±1 to 127±5 per mmHg, Diastolic BP increased from 72±8 to 78±7 per mmHg and Mean Artery Pressure (MAP) increased from 89±11 to 94±8 mm Hg. After ETT insertion: Mean pulse increased from 68±2 to 80±8 per minute, Systolic BP increased from 124±1 to 152±8 per mmHg, Diastolic BP increased from 72±8 to 96±8 per mmHg and MAP increased from 89±10 to 115±4 mm Hg.&#x0D; Conclusion: We concluded that Proseal LMA is safe. It is judged by: Stable hemodynamics, adequate oxygenation, and ventilation and less complications.

A Comparative Study between I-gel and Proseal LMA in Adult Patients Undergoing Elective Laparoscopic Cholecystectomy under General Anaesthesia

A Comparative Study between I-gel and Proseal LMA in Adult Patients Undergoing Elective Laparoscopic Cholecystectomy under General Anaesthesia

A Comparative Study of Pro Seal Laryngeal Mask Airway, i-gel and Combitube under General Anaesthesia for Elective Surgical Patients Requiring Controlled Ventilation

A Comparative Study of Pro Seal Laryngeal Mask Airway, i-gel and Combitube under General Anaesthesia for Elective Surgical Patients Requiring Controlled Ventilation

Use of Proseal Laryngeal Mask Airway (PLMA) and Endotracheal Tube (ETT) in Cardiac Compromise Patients with LVEF &lt;45% Undergoing Laparoscopic Cholecystectomy : A Comparison of Hemodynamic Parameters

Background: The major cause of sympatho-adrenal response to tracheal intubation is due to thestimulation of supraglottic region by tissue irritation induced by direct laryngoscopy. Direct laryngoscopyby activating proprioceptors, induces arterial hypertension, tachycardia and increased catecholamineconcentrationproportional to the intensity of stimulus exerted against the base of the tongue. Incardiac compromised patient, use of endotracheal tube (ETT) is associated with various hemodynamiccomplications, which are minimally affected during ProSeal laryngeal mask airway (PLMA) use. Objective: This prospective study was conducted with the objective of demonstrating the advantages ofPLMA over ETT in the patients undergoing laparoscopic cholecystectomy surgeries. Methodology: This prospective, interventional study was carried out in 60 patients who underwentlaparoscopic cholecystectomy surgeries. Patients were randomized in equal numbers to either ETTgroup or PLMA group, and various hemodynamic changes were observed at different time points. Results: Patients in PLMA group had mean systolic blood pressure 134.785±03.765 mm Hg comparedto the patients of ETT group 146.675±05.764 mmHg. Pulse rate in the PLMA group was less (94.267 ±05.678per min) (P &lt; 0.05) compared to ETT group (115.34±10.236).Thus, hemodynamic changes weresignificantly lower (P &lt; 0.05) in PLMA than in ETT group. The incidence of adverse events was alsolower in PLMA group. Conclusion: PLMA offers advantages over the ETT in airway management in the patients undergoinglaparoscopic cholecystectomy surgeries in cardiac compromise patients. JBSA 2018; 31(1): 38-44