STUDY
OBJECTIVE:
To compare the clinical use of four disposable laryngeal masks (DLMs): the Ambu laryngeal mask [Ambu LM], Solus, Laryngeal Mask Airway (LMA) Unique, and Soft Seal.
DESIGN:
Prospective, randomized study.
SETTING:
Operating room and recovery area of a university-affiliated ambulatory surgery unit.
PATIENTS:
200 adult ASA physical status I, II, and III patients, scheduled for ambulatory procedures.
INTERVENTIONS:
Patients underwent insertion of the DLM by nonexperienced residents.
MEASUREMENTS:
The time and number of attempts needed for insertion, quality of ventilation, airway sealing pressure at 60 cmH(2)O of intracuff pressure, and complications were all evaluated. MAIN
RESULTS:
Ease of insertion was greater (P = 0.03) and first attempt success rate was higher with the Ambu LM (78%) and LMA Unique (80%). The Solus most often needed three attempts to be placed (12 cases); the Ambu LM needed three similar attempts in two cases; the LMA Unique in 4 cases; and the Soft Seal in 5 cases (P = 0.018). The LMA Unique achieved the highest rate of optimal ventilation (46/49 cases) of the 4 groups.
Airway sealing pressure was significantly higher with the Soft Seal (27.3 +/- 5 mmHg), compared to the Ambu LM (23.7 +/- 5 mmHg), the Solus (20.9 +/- 4 mmHg), and the LMA Unique (22.1 +/- 6 mmHg) (P < 0.001). Blood staining of the DLM on removal was most frequent with the Soft Seal (38%).
CONCLUSIONS:
The Ambu LM and LMA Unique DLMs appear to be easier to insert by inexperienced residents and are less traumatic for the patient.
The Soft Seal achieves a higher airway seal than other devices, but it causes more mucosal trauma.
The Solus had the highest insertion failure rate of the 4 groups.
2008-12-01
Eng.
Journal of Clinical Anesthesia
Department of Anesthesiology and Reanimation, Hospital Clínic of Barcelona, University of Barcelona, Spain. analopez [at] clinic.ub.es
J Clin Anesth. 2008 Nov;20(7):514-20
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