Results 

 

 

Participating Operators. Five staff anesthetists, 2 anesthesia residents, and one qualified anesthesia nurse volunteered and participated in this study. They performed insertion attempts of the ProSeal Laryngeal Mask Airway (PLMA) on from 10 to 16 (median: 12) patients. The operators were experienced users of the GlideScope Video Laryngoscope (GVL) and the standard laryngeal mask airway, but had less experience with the use of the PLMA. 

 

Patient Demographics. During January and September 2007, 100 patients not requiring tracheal intubation for elective general surgical or urological operative procedures were enrolled into this study; none of these patients was excluded from the study because of difficult face-mask ventilation experienced during induction of general anesthesia. The demographic data of the patients are summarized in Table 1.

 

Video Laryngoscopic Views. During manipulation of the GVL, there were no minor problems and difficulties with impeded blade insertion due to limited mouth opening and/or restricted pharyngeal space and poor visibility due to the presence of secretions and/or fogging of the camera system. The GVL provided a panoramic view of anatomical structures for atraumatic insertion of the gastric tube (GT); the laryngeal views obtained were visualization of the entire laryngeal aperture and visualization of at least parts of the laryngeal aperture in 84 and 16 patients, respectively, and the esophageal lumen was visible in 74 patients.  

 

Performance of the Laryngeal Mask Airway. PLMA insertion and performance of the PLMA as an effective airway (the study design allowed only one PLMA insertion attempt) was successful in all patients. Cuff volumes required and cuff pressures measured [median (range)] were 16 (10 to 30) ml and 28 (18 to 44) mbar for size 4 PLMAs used in 44 patients and 20 (10 to 36) ml and 26 (18 to 40) mbar for size 5 PLMAs used in 56 patients, respectively.

 

Flexible Laryngoscopic Views through the Airway Tube. The laryngeal views through the airway tube of the PLMA obtained with the flexible fiberoptic laryngoscope were grade 1 and 2 in 60 and 40 patients, respectively; there were no statistically significant differences in the laryngeal views recorded with both sizes of the PLMA.

 

Gastric Tube Advancement for Gastric Drainage. In 48 patients, the GT was further advanced for gastric drainage; GT advancement into the correct position was successful at the first attempt in all these patients.    

 

Severe Complaints and Injuries Associated with Airway Mangement. Severe complaints and injuries (to oropharyngeal, laryngeal, and/or esophageal structures) associated with airway management were not observed at the postanesthesia care unit and during the postanesthesia visit on the first postoperative day at the normal ward.

 

 

Discussion