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Is ProSeal™ A Better Choice Than Classic™ Laryngeal Mask Airway For

Children? A Randomized Controlled Trial In The Anaesthetized Non-paralyzed


Daycare Children

NS Hadzarami1, Rohayu Othman2, Lucy Chan3

1
University of Malaya, Kuala Lumpur, Malaysia
2
Hospital Kuala Lumpur, Kuala Lumpur, Malaysia

We compared ProSeal™ and Classic™ laryngeal mask airway (LMA) in anaesthetized,


spontaneously breathing children in daycare surgery in terms of number of attempts of
insertion, airway sealing pressure, grading at fibreoptic visualization and frequency of
gastric insufflation.

A total of 60 children (age 1-6 years old) were studied in a non-crossover manner. The
patients were randomized for airway management with the size 2 ProSeal™ or Classic™
LMA. After induction of general anaesthesia, the ProSeal™ LMA or Classic™ LMA was
inserted. The number of attempts of insertion was counted; airway sealing pressure
measured and placement was confirmed by fibreoptic visualization. Upon completion of
surgery, the laryngeal mask airway was removed and any complication was documented.

We found that fibreoptic position grade 4 was higher in ProSeal™ LMA group (P=0.028)
but the overall fibreoptic position grade was similar for both Proseal™ and Classic™
LMA. There was no statistical difference between the two groups for the success rates at
first attempt of insertion, airway sealing pressure and frequency of gastric insufflation.
Gastric tube insertion in ProSeal™ LMA had a 100% success rate.

We conclude that the performance of both ProSeal™ and Classic™ LMA was similar in
terms of insertion and placement in the anaesthetized daycare children. Although
ProSeal™ LMA provided a better anatomical position than Classic™ LMA, it showed no
definite advantage over Classic™ LMA in term of general airway management for
children in daycare surgery setting.

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