Malposition of the ProSeal Laryngeal Mask

Failed gastric tube insertion in the LMA‐ProSeal®

“…Recent papers have recognised that inability to pass a gastric tube is a common indicator of poor mask position; usually due to the tip of the mask folding over and occluding the drain tube [1,2]. It is noteworthy that in .............................................................................................................................................................................................................. We cannot support the insertion technique described by Drs Hartopp and Maynard.…”

“…To ensure patient safety most endovascular monitoring devices containing wires of conductive metallic material are not approved for use in MRI either because they move due to magnetic translational attraction and torque or cause burns due to heating effects [1][2][3][4][5]. This is particularly relevant in patients under general anaesthesia who are unable to indicate any sensation of heat.…”

“…Attaching monitoring or connecting cables would change the experiment as they would be exposed to the RF field only in part, making it difficult -if not impossible -to predict or simulate any possible interference. The reported burns during MRI [2][3][4][5] …”

“…The neurological features exhibited by the patient (nystagmus, unresponsive dilated pupils, rigidity, clonic limb movements, agitation, aggression and sweating) are not typical of MB toxicity, the presentation of which includes headache, dizziness, restlessness, and mental confusion. However, the recognised neurological side-effects of fluoxetine, which inhibits central nervous system neuronal uptake of serotonin and is used for treatment of major depression and obsessive compulsive disorder, include anxiety, dizziness, tremor, ataxia, akathisia, myoclonus and convulsions [2]. Little is known about the neurological effects of PB toxicity.…”

“…Daily oral administration of fluoxetine 40 mg results in plasma levels which in vitro allow 95% of the drug to be bound to albumin and alpha-1-glycoprotein. Adverse effects may result from displacement of protein bound fluoxetine by other tightly bound drugs, such as PB, and vice versa [2]. No information is available concerning interaction of MB with other substances [2].…”