cuff volume and size laryngeal mask Airway

BACKGROUND: Hyperinflation of laryngeal mask cuffs may carry the risk of airway complications. The manufacturer recommends inflating cuff until the intracuff pressure reaches 60 cmH2 O, or inflate with the volume of air to not exceed the maximum recommended volume. We prospectively assessed the correlation of cuff inflating volumes and pressures, and the appropriated the cuff inflating volumes to generate an intracuff pressure of 60 cmH2 O in the adult laryngeal masks from different manufacturers...

BACKGROUND: This study were designed to investigate the usefulness of the videolaryngoscope-guided insertion technique compared with the standard digital technique for the insertion success rate and insertion conditions of the Proseal™ laryngeal mask airway (PLMA). METHODS: Prospective, one hundred and nineteen patients (ASA I-II, aged 18-65 yr) were randomly divided for PLMA insertion using the videolaryngoscope-guided technique or the standard digital technique...

BACKGROUND AND AIMS: Second generation supraglottic airways are increasingly being used in surgical patients undergoing laparoscopic surgery. Preventing aspiration at higher airway pressures may be at the expense of a higher cuff pressure which can impair mucosal perfusion. We attempted to elucidate whether Ambu AuraGain™ (AAU) would provide a higher oropharyngeal leak pressure (OLP) with a lower mucosal pressure in comparison to ProSeal™ laryngeal mask airway (PLMA). METHODS: This was a prospective randomised study involving sixty patients undergoing laparoscopic cholecystectomy under general anaesthesia, using either AAU (Group AAU [ n = 30]) or PLMA (Group PLMA [ n = 30]) for elective ventilation...

We present a case of confusing white foreign body in the nasal cavity detected during Endoscopic Sinus Surgery (ESS) in a 35-yr-old male which turned out to be a malposition of classic laryngeal mask airway (LMA). Although malposition of LMA is a known entity to the anesthesiologist, if ventilation is adequate, back folded LMA in nasal cavity might not be recognized by the surgeon and lead to catastrophic consequences during endoscopic sinus surgery. In principle, misfolding and malpositioning can be reduced by pre usage testing, using appropriate sizes, minimizing cuff volume, and early identification and correction of malposition...

BACKGROUND: High intracuff pressure can cause severe pharyngeal complications including sore throat or hoarseness after laryngeal mask airway (LMA) removal postoperatively. Though the application of minimum effective cuff inflating volume is suggested to maintain airway sealing and adequacy of ventilation for patients receiving general anesthesia with LMA at lower level of the intracuff pressure, it is currently not a standard care in most of the anesthetic departments. In this study, the minimum effective cuff inflating volume was determined for classic LMA Well Lead™ (Well Lead Medical Co...

OBJECTIVE: The aim of this study was to compare size 2 Laryngeal Mask Airway ProSeal and size 2 Laryngeal Mask Airway Supreme in spontaneously breathing children undergoing lower abdominal elective surgery of <1 hour duration. STUDY DESIGN: Randomized clinical trial. MATERIAL AND METHODS: Sixty children aged 1-7 years, weighing 10-20 kg, ASA I physical status were randomly allocated to the Laryngeal Mask Airway ProSeal and Laryngeal Mask Airway Supreme...

The Tulip airway is an adult, disposable, single-sized oropharyngeal airway, that is connectable to an anaesthetic circuit. After a standardised induction of anaesthesia in 75 patients, the ease of insertion, intracuff pressure and intracuff volume were measured, as were the end-tidal carbon dioxide levels, airway pressures and tidal volumes over three breaths. Successful first-time insertion was achieved in 72 patients (96%, CI 88.8-99.2%) and after two attempts in 74 patients (99%, CI 92.8-100%). There was outright failure only in one patient...

PURPOSE: The incidence of postoperative pharyngolaryngeal complications after laryngeal mask airway (LMA) insertion can be as high as 50%. Over-inflation of the LMA cuff may be a causal factor. We conducted a single-centre parallel group randomised trial to determine whether maintaining LMA-ProSeal intra-cuff pressures below 60 cm H2O decreases postoperative pharyngolaryngeal complications. METHODS: We recruited 120 adult patients who were scheduled to undergo elective surgery under general anaesthesia...

PURPOSE: This single-center, prospective, randomized, double-blind, 2-arm, parallel group comparison trial was performed to establish whether the adult-sized laryngeal mask airway (LMA) Classic (The Laryngeal Mask Company Ltd, Henley-on-Thames, UK) could be used safely without any consideration of cuff hyperinflation when a cuff of the LMA Classic was inflated using half the maximum inflation volume or the resting volume before insertion of device. BASIC PROCEDURES: Eighty patients aged 20 to 70 years scheduled for general anesthesia using the LMA Classic were included...

BACKGROUND: Anaesthetic complications, albeit rare, still occur and may be severe and unanticipated, with significant morbidity. Extracranial ipsilateral palsy of the recurrent laryngeal and the hypoglossal nerves is known as the Tapia's syndrome. Damage to these nerves may result from displacement of the head during mask ventilation, endotracheal intubation, bronchoscopy or the use of a laryngeal mask airway (LMA). We describe unilateral paralysis of the muscles of the tongue and ipsilateral vocal cord due to a lesion of cranial nerves X and XII that occurred following LMA anaesthesia combined with plexus block...

BACKGROUND: Clinical end points are often used to guide inflation and adequacy of cuff seal after laryngeal mask airway placement. However, clinical end points for cuff inflation have been shown to have significantly higher intracuff pressure. The adjusted cuff pressure between 55 and 60 cm H(2)O causes significantly better seal of laryngeal mask airway. We prospectively assessed the cuff pressures generated by cuff inflation guided by clinical end points, and the actual volume of air required to achieve cuff pressures between 55 and 60 cm H(2)O for sizes 1-2...

BACKGROUND: The cuff of the laryngeal mask airway (LMA) is preferred to be partially inflated before insertion in pediatric cases. However, it is not known how much inflation is appropriate. In addition, intra-cuff pressure is not routinely monitored in many institutions despite the fact that a neglected high cuff pressure could cause several complications. This study was conducted to determine whether the cuff inflated with its resting volume before insertion could have a clinically tolerable intra-cuff pressure after insertion...

BACKGROUND: Although the cases of upper airway obstruction with ProSeal laryngeal mask airway (PLMA) during spontaneous respiration were reported, the structural comparison with other types of laryngeal mask are not known. We thus examined the relationship between upper airway obstruction and the structure of laryngeal mask. METHODS: With approval of the human research committee at Kawanishi City Hospital, and written informed consent, we enrolled 27 patients scheduled for elective surgery...

BACKGROUND: Unintended hyperinflation of the cuff of a laryngeal mask airway (LMA) has been associated with increased airway morbidity and postoperative pain. While the manufacturers recommend a cuff pressure of less than 60 cmH(2)O, in usual clinical practice, there is no method used to determine intracuff pressure of an LMA. The purpose of this prospective quality assurance study is to evaluate the incidence of LMA hyperinflation and excessive intracuff pressure in a busy tertiary care pediatric hospital...

BACKGROUND: This study examined whether changing the head position from neutral to side can affect expiratory tidal volume (TV) and cuff pressure when the appropriate sizes of a Proseal™ Laryngeal Mask Airway (PLMA)-depending on the body weight -are used in pediatric patients during pressure controlled ventilation (PCV). METHODS: Seventy-seven children (5-30 kg) were divided into three groups according to their body weight, PLMA#1.5 (group I, n = 24), #2 (group II, n = 26), and #2...

BACKGROUND: Optimal inflation of the laryngeal mask airway (LMA) cuff should allow ventilation with low leakage volumes and minimal airway morbidity. Manufacturer's recommendations vary, and clinical end-points have been shown to be associated with cuff hyperinflation and increased leak around the LMA. However, measurement of the intra-cuff pressure of the LMA is not routine in most pediatric institutions, and the optimal intra-cuff pressure in the LMA has not been determined in clinical studies...

BACKGROUND AND OBJECTIVE: The I-gel is a new single-use supraglottic airway device without an inflatable cuff. This study was designed to investigate the usefulness of the I-gel compared with the classic laryngeal mask airway (cLMA) and ProSeal laryngeal mask airway (pLMA) in anaesthetized, paralysed patients. METHODS: The American Society of Anesthesiologists physical status I-II patients (n = 167) scheduled for orthopaedic surgery were included in this prospective study...

BACKGROUND: Hyperinflation of the laryngeal mask airway (LMA) cuff is known to be a risk factor for airway morbidity and increased leakage around the LMA. While the manufacturers' recommendation is to inflate the cuff with the maximum recommended volumes and/or to adjust the cuff pressure to <60 cmH2O, cuff pressures below 40 cmH2O have been shown to be associated with a minimal rate of sore throat and minimal leakage. However, it remains to be determined whether inflation or deflation is needed to achieve favorable pressures...

PURPOSE: We hypothesized that the simultaneous use of low concentrations (<6%) of desflurane, nitrous oxide (N(2)O), and fentanyl would allow a laryngeal mask airway (LMA) to be inserted safely with inhalation induction of desflurane, even in nonparalyzed patients. This prospective, observational study was performed to determine the 50% effective concentration (EC(50)) of desflurane for LMA insertion in such patients. METHODS: Twenty-two adult patients undergoing ambulatory surgical procedures under general anesthesia using an LMA were included in the study...

Hyperinflation of the laryngeal mask airway cuff may exert high pressure on pharyngeal and laryngeal structures. In vitro data show that high intra cuff pressures may occur when inflated to only 30% of the manufacturer's recommended maximum inflation volume. We prospectively assessed the pressure volume curves of paediatric sized laryngeal mask airways (size 1-3) in 240 consecutive children (0-15 years). Following laryngeal mask airway insertion the cuff was inflated with 1-ml increments of air up to the maximum recommended by the manufacturer...