Preliminary evaluation of a new prototype laryngeal mask in children

We have assessed a prototype laryngeal mask airway (pLMA) in 50 anaesthetized children for ease of insertion, oropharyngeal leak pressures, gastric insufflation and fibreoptic position. The pLMA has a second smaller mask, which rests against the upper oesophageal sphincter, and a second cuff to increase the seal pressure of the glottic mask. All insertions were graded as easy and an effective airway was achieved in all patients. Oropharyngeal leak pressure was > 40 cm H2O in 49 of 50 patients. Gastric insufflation was not detected by epigastric auscultation. In 46 of 50 patients, the vocal cords were seen via a fibreoptic laryngoscope. One patient regurgitated clear fluid, but aspiration did not occur. On removal, blood staining was detected in three of 50 children. We conclude that the pLMA was easy to insert, facilitated high airway pressure ventilation and may provide some protection against gastric insufflation.