Size 2.5 ProSeal(™) LMA: Is it associated with increased attempts at insertion?

Area of Science:

• Anesthesiology
• Medical Devices
• Pediatric Care

Background:

• Evaluating ProSeal™ laryngeal mask airway (PLMA) insertion techniques in children.
• Comparing digital (D) versus introducer tool (IT) insertion methods.
• Assessing oropharyngeal morbidity associated with PLMA use.

Purpose of the Study:

• To compare the success rate and oropharyngeal morbidity of PLMA insertion using digital (D) versus introducer tool (IT) techniques.
• To evaluate different PLMA sizes (1.5, 2, and 2.5) in pediatric patients.
• To determine the optimal insertion method for pediatric PLMA use.

Main Methods:

• Randomized controlled trial involving 250 children (6 months to 10 years).
• PLMA insertion using digital (D) or introducer tool (IT) techniques.
• Primary outcomes: first-attempt insertion success and blood on device; secondary outcomes: leak pressure and gastric tube placement.

Main Results:

• No significant difference in first-attempt success for PLMA sizes 1.5 and 2 between D and IT groups.
• Size 2.5 PLMA showed significantly lower insertion success in both groups.
• Higher incidence of blood on device for size 2.5 PLMA, particularly with the D technique.

Conclusions:

• Size 2.5 PLMA is associated with reduced insertion success and increased bleeding risk.
• The digital technique (D) for PLMA insertion is a viable alternative to the introducer tool (IT) technique for sizes 1.5 and 2 in pediatric patients.