We conclude that ease of insertion and airway sealing pressure are similar between the LMA-ProSeal and the LMA-Classic in children.

We studied how head and neck position affect the cuff position and oropharyngeal sealing pressures of the laryngeal mask airways (LMAs) in children. We studied 39 non-paralyzed healthy children aged 1.5-8.0 yr, weighing 10.3-27.0 kg, managed with size 2 or 2.5 LMAs during elective surgery. Head and neck movements did not adversely affect airway patency in 97% of patients. One child developed apparent airway obstruction with head and neck flexion, which was relieved in the neutral position. Oropharyngeal sealing pressure was significantly greater during neck flexion compared with the neutral position (P<0.02). Fibreoptic examination revealed that the epiglottis covered a larger area of the LMA aperture during neck flexion, compared with the neutral position (P<0.02).

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare sensory neuropathy, which affects patients' pain sensation and thermoregulation. There are several issues to consider when planning anaesthesia for those with this congenital disorder. Over a 20-year period, six patients with CIPA underwent 20 surgical procedures under general anaesthesia in our institution. We analysed our experience with these patients retrospectively. We conclude that patients with CIPA are able to undergo surgical procedures under general anaesthesia without major problems.

A higher airway seal is believed to be one of the clinical signs correlating with the correct position of an LMA. We found no relationship between oropharyngeal sealing pressure and LMA cuff position in paediatric patients.

The direct auscultation technique was more rapid and accurate than any other techniques to determine cardiac activity without instruments. It is suggested that direct a auscultation technique is also superior to the palpation of brachial artery in cardiopulmonary resuscitation in infants.