A prospective, observational evaluation of a new supraglottic airway: the PAXpress

Little information is available on efficacy and safety of the new supraglottic device, PA(Xpress), in anesthetized patients. The aim of this prospective observational study was to evaluate the use of this new supraglottic device in clinical practice.

Ninety-one patients (mean age: 45+/-11 years) undergoing extremity or minor peri-phery procedures (mean duration 53+/-18 min), with a supraglottic airway were prospectively studied in 10 hospitals, using a simple questionnaire with data concerning anthropometric variables, surgical procedure, and occurrence of untoward events during PA(Xpress) placement, anesthesia maintenance, or postoperative period.

First attempt placement was achieved in 74 patients (82.2%), while 9 patients (10%) required 2 attempts, and 7 patients (7.7%) required more than 2 attempts. In only 2 patients (2%) airway control was not achieved with the studied device. The mean time required to achieve successful placement was 49+/-18 s (range 4-300 s). Mechanical ventilation was effectively maintained in all studied patients, and no severe adverse events were reported during the procedure. Blood on the device was observed in 54% of cases, and this was associated with an incidence of sore throat of 26% in the recovery area and 13% after 6 hours from the end of surgery.

Although further comparative, randomized studies should be advocated to better evaluate the use of this new supraglottic device, this prospective, observational study demonstrated that PA(Xpress) provides safe and effective airway control during mechanical ventilation in up to 98% of cases.