Comparison of weight-based and pinna size-based selection of ProSeal laryngeal mask airway in paediatric population - A prospective exploratory trial.

Background and Aims: Weight-based selection of ProSeal laryngeal mask airway (PLMA) size may be unreliable in some situations. The aim of this study was to compare the ventilation parameters using PLMA during controlled ventilation between weight-based size selection and pinna size-based selection in children.

Methods: A total of 204 patients were randomised to receive either pinna size-based (Group P) or weight-based (Group W) size selection of PLMA. We tested the hypothesis that pinna size-based selection of PLMA was better than weight-based selection of PLMA in paediatric patients during controlled ventilation under general anaesthesia in terms of oropharyngeal sealing pressure (the primary end-point) and Brimacombe score. Cuff pressure was maintained at 60 cm of H2 O during the study. Secondary outcomes included the number of attempts for successful placement of PLMA, peak airway pressure, gastric tube placement, traumatic insertion, and complications were also compared. Parametric variables were analysed using unpaired t -test and categorical variables were analysed using Mann-Whitney and Chi-square test.

Results: In all, 200 patients were analysed. The mean oropharyngeal sealing pressure in Group P was 25.4 ± 3.5 cmH2 O and 24.9 ± 3.8 cmH2 O in Group W, ( P = 0.34). There was no significant difference between the two groups in any of the secondary outcomes. There were no traumatic insertion or complications reported in both the groups.

Conclusion: Pinna-based size selection method can be used in PLMA placement in the paediatric population for positive pressure ventilation and it serves as an alternative method to weight-based selection.