Comparison of leakage test and ultrasound imaging to validate ProSeal supraglottic airway device placement

To validate the placement of ProSeal supraglottic airway device using ultrasound (USG) with leakage test in adult population of both sexes.

This single-arm observational study was conducted on 80 American Society of Anesthesiology (ASA) I-III patients, undergoing elective surgery under general anesthesia with ProSeal supraglottic airway device. Leakage pressure test was conducted in all cases. The position of the ProSeal laryngeal mask airway (LMA) was assessed by USG in the pharyngeal, laryngeal, and the cranial-caudal axis plane. The fiberoptic examination was done to confirm the position of ProSeal if the seal pressure was <27 cm H₂O, to confirm suboptimal placement. The position of the ProSeal in the three USG planes was allocated a predetermined score. This score was compared with the leakage test to determine the strength of the correlation, sensitivity, and specificity for predicting a need for reinsertion.

Leakage seal pressure was recorded as <27 cm H₂O in 6 (7.5%) patients and fiberoptic bronchoscopy was done in these cases to determine the need for reinsertion. ProSeal was reinserted in 5 (6.25%) cases. Patients with a composite ultrasound score of 0-1 required ProSeal reinsertion while those with a score of 2-3 did not require reinsertion. Seventy-one patients had seal pressure >27 cm H₂O and a score of 3. USG examination is comparable with leakage test in predicting the requirement of reinsertion (P = 0.003) and a score of 19 equating 0-1 predicted the need for reinsertion with a sensitivity and specificity of 80% and 100%, respectively.

USG is comparable with the leakage test for confirmation of ProSeal placement.