Laryngeal mask airway ProSeal provides higher oropharyngeal leak pressure than i-gel in adult patients under general anesthesia: a meta-analysis

Maitra, Souvik; Baidya, Dalim Kumar; Arora, Manali; Bhattacharjee, Sulagna; Khanna, Puneet

doi:10.1016/j.jclinane.2016.04.020

Cited by 20 publications

(14 citation statements)

References 17 publications

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“…However, our data are in line with those reported for the LMA Protector in previous studies . The OLP of the LMA Protector was comparable to or even higher than that described for the ProSeal and the Ambu AuraGain, and superior to that of the i‐gel and the LMA Supreme; this finding may be related to the cuff material and design of the LMA Protector .…”

Section: Discussionsupporting

confidence: 92%

“…The overall success rate of the LMA Protector found in our present study (98%) is comparable to other second‐generation SADs such as the LMA ProSeal TM (91–100%), the LMA Supreme TM (92–100%) and the Ambu AuraGain (92–100%), but inferior to the Classic TM LMA (99.8–100%) . The learning curve with the LMA Protector is probably steeper than that of first‐generation SADs and similar to that of second‐generation SADs, which may justify the fact that 56% of our patients required manoeuvres to facilitate insertion . However, our data are in line with those reported for the LMA Protector in previous studies .…”

Section: Discussionsupporting

confidence: 74%

“…A recent report with a new silicone SAD, the LMA Gastro TM airway, which shares some features with the LMA Protector, reported the presence of blood staining in 76% of 292 patients . The incidence of blood staining after SAD removal ranges between 0% and 50%, and is related to differences in difficulty of insertion, provider experience and patient characteristics .…”

Section: Discussionmentioning

confidence: 99%

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The LMA^® Protector^TM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study

Zaballos

Zaballos²,

López

et al. 2019

Anaesthesia

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We evaluated the LMA â Protector TM in 280 ASA physical status 1-3 patients aged 18-75 years by assessing the ease of insertion, insertion time, oropharyngeal leak pressure, ease of gastric tube passage and complications. First-attempt and overall insertion success was 234/280 (84; 95%CI 79-88%) and 274/280 (98; 95-99%). Median (IQR [range]) insertion time was 17 (12-25 [5-44]) s, and manoeuvres to facilitate insertion were required in 56 (50-63)% of patients. Median oropharyngeal leak pressure was 31 (26-36 [14-40]) cmH 2 O. Multivariate analysis identified two risk factors for oropharyngeal leak pressure < 25 cmH 2 O: male sex (OR 2.44; 1.01-5.91, p = 0.048) and the insertion of a LMA size different to that recommended by weight (OR 1.98; 0.97-4.03, p = 0.06). Gastric tube insertion was possible in 256 out of 274 patients (93%). On fibreoptic view, vocal cords were visible in 86% of patients. During maintenance, 14 patients (5%) required airway manipulation. There were no episodes of regurgitation or aspiration. Blood staining on LMA removal was present in 70 out of 280 patients (25%). Use of the LMA Protector appears safe and is associated with a high success rate, provision of a highly effective seal and low rates of clinical complications. These attributes would suggest considerable potential for use during anaesthesia.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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The LMA^® Protector^TM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study

Zaballos

Zaballos²,

López

et al. 2019

Anaesthesia

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“…It is also used to evaluate the effectiveness of different airway devices [23]. Seet et al reported that OLP was 21 cmH 2 O in 99 cases in which the LMA-S was used with an intracuff pressure of 60 cmH 2 O [24].…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Laryngeal Mask Airway-Supreme and Endotracheal Tube Use with respect to Airway Protection in Patients Undergoing Septoplasty: A Randomized, Single-blind, Controlled Clinical Trial

Karaaslan

Akbaş

Özkan

et al. 2019

Preprint

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Background There are doubts among anesthesiologists on the use of the Laryngeal Mask Airway in nasal surgeries because of concerns about the occurrence of blood leakages to the airway. The primary purpose of this study on septoplasty cases was to compare Laryngeal Mask Airway-Supreme (LMA-S) and endotracheal tube (ETT) use in protecting the airway against blood leakage, as evident through the fiberoptic bronchoscopy method. The secondary purpose of the study was to evaluate oropharyngeal leakage pressure (OLP), heart rate (HR), mean arterial pressure (MAP), and postoperative adverse events.Methods The present study was conducted in a prospective, randomized, single-blind, controlled manner on 80 patients, who underwent septoplasty procedures under general anesthesia, after dividing them randomly into two groups according to the device used (LMA-S or ETT). The presence of blood in the airway (glottis/trachea, distal trachea) was analyzed with the fiberoptic bronchoscope and a four-point scale. Both groups were evaluated for OLP; HR; MAP; postoperative sore throat, nausea, and vomiting; dysphagia; and dysphonia.Results In the fiberoptic evaluation of the postoperative airway, less blood leakage was detected in both anatomic areas in the LMA-S group than in the ETT group (glottis/trachea, p = 0.004; distal trachea, p = 0.034). Sore throat was detected less frequently in the LMA-S group at a significant level in the 2nd, 6th, and 12th hours of postoperative period; however, other adverse events were similar in both groups. Hemodynamic parameters were not significantly different between the two groups.Conclusion The present findings demonstrate that the LMA-S provided more effective airway protection than the ETT in preventing blood leakage in the septoplasty procedures. We believe that the LMA-S can be used safely and as an alternative to the ETT in septoplasty cases.

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“…[2][3][4][5] Por consiguiente, aumenta las posibilidades de éxito en pacientes con trastornos de distensibilidad u obstrucción pulmonar. 6,7 Existen diferentes tipos de dispositivos de LMA, cada uno con diferentes diseños y materiales fabricados, y cada cual creado para condiciones y usos específicos en el paciente. Así, los dispositivos disponibles son Clásica TM LMA, i-gel TM , Fastrach TM , ProSeal TM , Supreme TM y Unique TM , entre otras marcas registradas.…”

Section: Introductionunclassified

Related factors for ProSeal™ laryngeal mask airway failure

Billefals-Vallejo

Isaza-Sánchez

López-Gil

et al. 2019

Colombian Journal of Anesthesiology

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Laryngeal mask airway ProSeal provides higher oropharyngeal leak pressure than i-gel in adult patients under general anesthesia: a meta-analysis

Cited by 20 publications

References 17 publications

The LMA^® Protector^TM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study

The LMA^® Protector^TM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study

A Comparison of Laryngeal Mask Airway-Supreme and Endotracheal Tube Use with respect to Airway Protection in Patients Undergoing Septoplasty: A Randomized, Single-blind, Controlled Clinical Trial

Related factors for ProSeal™ laryngeal mask airway failure

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Laryngeal mask airway ProSeal provides higher oropharyngeal leak pressure than i-gel in adult patients under general anesthesia: a meta-analysis

Cited by 20 publications

References 17 publications

The LMA® ProtectorTM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study

The LMA® ProtectorTM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study

A Comparison of Laryngeal Mask Airway-Supreme and Endotracheal Tube Use with respect to Airway Protection in Patients Undergoing Septoplasty: A Randomized, Single-blind, Controlled Clinical Trial

Related factors for ProSeal™ laryngeal mask airway failure

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Product

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The LMA^® Protector^TM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study

The LMA^® Protector^TM in anaesthetised, non‐paralysed patients: a multicentre prospective observational study