Laryngeal mask lubrication. A comparative study of saline versus 2% lignocaine gel with cuff pressure control

We compared 2% lignocaine gel with saline as a lubricant for the laryngeal mask airway in 126 patients receiving positive pressure ventilation in whom cuff pressures were limited to 60 cmH2O and peak airway pressures to less than 17 cmH2O. The incidence of sore throat was similar for both groups and there were no emergence problems. There were significantly more intra- and postoperative complications in the lignocaine group (p < 0.05) but the frequency of sore throat was similar when the device was inserted at the first attempt. Positive pressure ventilation to normal end-tidal CO2 values was possible in all patients. Lignocaine gel is an unsuitable lubricant for the laryngeal mask airway. Cuff pressure limitation to 60 cmH2O does not necessarily impede ventilation and may be an important factor in reducing emergence and postoperative complications.