Prospective randomized study comparing the standard weight-based method and a novel method based on combined width of index, middle and ring fingers for ProSeal laryngeal mask airway size selection in paediatric patients

Abstract

Introduction: Appropriate size selection of ProSeal laryngeal mask airway (PLMA) is an important prerequisite for successful use of the device. Size of PLMA is often selected based on weight of patients. We aimed to determine whether combined width of patient's index, middle and ring fingers could be used as an alternative to weight-based selection of appropriate size of PLMA. Materials and methods: In this prospective randomized study, 102 patients aged 6 months to 10 years were included. Patients were allocated to one of two groups based on a randomization table and PLMA inserted according to the group allocated. In Group S, PLMA size selected according to weight-based method whereas in Group N, PLMA size was selected based on 3-finger breadth of patients. We recorded insertion parameters, fiberoptic scoring of glottic visualisation, airway manipulations and postoperative complications. Results: In 68 children (66.66%) size of PLMA was same according to both methods. The kappa coefficient was 0.461 concluding moderate agreement between two methods. In the remaining 34 children (33.34%), the disagreement in sizes were with only one size, in whom the patient's weights were borderline values. The PLMA insertion time, ease of insertion, insertion attempts, fiberoptic view of position of device were comparable in both groups. There were no significant complications in the postoperative period. Conclusion: Three finger breadth sizing method can be used as a good alternative to weightbased method for selecting appropriate size of PLMA in children.

Comparison of standard weight-based and thenar eminence dimension-based selection of I-gel in pediatric patients – A randomized controlled study

“…The width of the index, middle, and ring fingers was also used to determine the size of in the prospective randomized study by Mathew et al . [ 11 ] in pediatric patients. They reported that the size of PLMA was the same in both methods in 66.66% of the children, but was inconsistent in 33.34%, with only one size in those whose weight was borderline.…”