An Audit of the Single Use Portex Laryngeal Mask

Abstract

We performed an audit of the insertion of the Single Use Portex Laryngeal Mask in 400 patients. Insertion was successful at first attempt in 335 out of 400 patients (83.8%). However in 15 patients (3.8%), the Portex laryngeal mask could not be placed despite repeated attempts. In 12 of these 15 patients (80%), a standard Laryngeal Mask Airway (LMA) was successfully placed. After the completion of the audit, 22 out of 29 anaesthetists (75.9%), who had inserted 5 Portex laryngeal masks, considered it inferior to the standard LMA. It would appear to us that the Portex laryngeal mask might need some design modifications to be a real alternative to the standard LMA.

A randomised comparison of the Portex Softseal™ laryngeal mask airway with the LMA‐Unique™ during anaesthesia

“…Reported first time insertion success with the Softseal ™ ranges from 79%[3] to 95%[1] and overall success from 96%[2] to 100%[1, 4]. Our results are reasonably consistent with this spread of performance.…”

“…Most studies of the Softseal ™ report an improved airway seal compared to the reusable LMA [1–3] and compared to the LMA‐Unique ™ [4]. We also found this in this study, but it was not associated with improved ventilation success or positioning of the device over the larynx.…”

“…This study should therefore not be seen as endorsing the use of single use laryngeal mask airways. Both devices in this study and several others [1–5] perform less well than the reusable laryngeal mask airway in many studies [3, 21]. In our opinion, further research to establish both the efficacy and the safety of single use laryngeal masks is sensible before widespread use.…”

“…Of note is that the instruction manuals for both devices recommend use of a size 4 and 5 for adult females and males and full deflation of the device prior to insertion [9, 10]. Some authors have however, suggested that the Softseal ™ may perform better if a relatively smaller size is selected [2]. Other authors have reported a lower incidence of sore throat when a reusable laryngeal mask airway is inserted partially inflated [16], even though this is not recommended by the manufacturers [11].…”

“…There are few trials comparing the performance of these devices either with the reusable device or between devices. At the time of writing there were only five publications relating to single use laryngeal mask airways [1–5].…”