ABSTRACT: Background. The purpose of this study was to evaluate the cuff pressures of four different laryngeal masks in paediatricpatients undergoing routine surgery and to determine whether there is a substantial increase in cuff pressure whensilicone masks are used compared to PVC laryngeal mask airways.Methods. Hundred and forty patients aged < 16 yr were randomly allocated to receive one of four extraglottic airwaydevices: LMA-Classic; LMA-Unique; Soft Seal; or Cobra-PLA. Intracuff pressure was monitored continuously throughoutthe operative intervention. The primary outcome was measurement of an increase in cuff pressure. First attempt successrate, effective airway time, anatomical position of the airway and incidence of airway morbidity data were monitored.Results. Mean cuff pressure increased within 5 min of N2O exposure, and was substantially higher in the silicone LMA-C,compared to the PVC-based extraglottic airway devices tested, reaching a plateau of the cuff pressure after 45 min.The overall first attempt success rate (97%) and the mean effective airway time (24 ± 9 sec) were very satisfactoryand all patients underwent successful surgery. Anatomical position was adequate in most airways, although in 34%of the patients in the Cobra group herniation of either the epiglottis or arytenoids were detected. Airway morbiditydue to the devices was insignificant.Conclusions. This study demonstrated a substantial increase in cuff pressure during anaesthesia for children in whoma silicone-based LMA-C was used, whereas PVC-based extraglottic airway devices showed a much lower increase.
Anaesthesiology intensive therapy. 01/2012; 44(2):63-70.
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