Inadequate ventilation with the LMA ProSeal^TM

Abstract

A recent letter studied different countries' positions in the field of anaesthesia in the period 1991 to year 2000 (Rahman et al. Anaesthesia 2002; 57: 1213-14). Among other things, the analysis elicited the top ranking 20 countries for research in the field of anaesthesia. Also, they revealed countries where research shares went down and up, respectively. The results were interesting, but one sentence puzzled me. The authors write: 'Journals not available in the Medline database for the entire 1991-2000 period were excluded (Acta Anaesthesiologica Scandinavica and Clinical Journal of Pain). To my knowledge, which is substantiated by a recent search in Medline, both journals have been available in the Medline database for the entire period (Table 1). I would be pleased if the authors could explain this difference.

Fixation of the ProSeal™ Laryngeal Mask Airway with a gauze bandage

“…Although the PLMA may initially be positioned correctly, with its tip fitting securely against the upper oesophageal sphincter, malposition may develop subsequently if the fixation method is inappropriate. Gupta & Ravalia [3] described inadequate ventilation with the PLMA and Brain & Verghese [4], in reply, explained why the author's use of adhesive tape applied to the mandibular arch was inappropriate. In this position, the tapes cannot transmit the required inward force on the device, necessary to ensure its distal end remains pressed against the upper oesophageal sphincter.…”