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Comparison of the modified Airway Management Device with the Proseal laryngeal mask airway in patients undergoing gynaecological procedures

Published online by Cambridge University Press:  23 December 2005

L. L. Pay  and
Y. Lim
L. L. Pay
Affiliation:
KK Women's and Children's Hospital, Department of Women's Anaesthesia, Singapore
Y. Lim
Affiliation:
KK Women's and Children's Hospital, Department of Women's Anaesthesia, Singapore
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Summary

Background and objective: The modified Airway Management Device (AMD) and the Proseal laryngeal mask airway (PLMA) are both supraglottic airway devices designed to maintain airway patency and allow ventilation during anaesthesia. In this prospective, randomized trial, we compared the two devices in patients undergoing major gynaecological procedures. Methods: Eighty-two patients undergoing elective gynaecological surgery were randomized to two groups. Group A (n = 41) had the AMD and Group P (n = 41) the PLMA inserted after induction of anaesthesia. We compared the success of airway placement, time to achieve an airway, oropharyngeal leak pressure and complications associated during anaesthesia. Results: There were no differences in patient characteristic profile for both groups. First time insertion success rates were significantly higher in Group P than in Group A (100% vs. 83%, P < 0.012). Time taken to achieve airway was also significantly shorter in Group P than in Group A (mean 21.9 ± 7.8 s vs. 40.2 ± 48.0 s, P < 0.001). The oropharyngeal leak pressure was significantly higher for Group P than Group A (mean 31.2 ± 5.7 cmH2O vs. 24.2 ± 8.3 cmH2O, P < 0.001). Ten patients in Group A had transient loss of airway during anaesthesia and needed manipulation of the airway device and four patients needed to have the airway switched to PLMA for the rest of the procedure. Conclusions: The modified AMD has a significant lower first time successful placement rate, required a longer insertion time and has a lower oropharyngeal leak pressure than the PLMA. It also demonstrated an increased loss of airway during anaesthesia. The modified AMD needs further evaluation on its efficacy and safety before its further use can be recommended.

Keywords

LARYNGEAL MASKSRESPIRATIONANAESTHESIA GENERAL, equipment, airway management devices
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 1 , January 2006 , pp. 71 - 75
Copyright
© 2006 European Society of Anaesthesiology

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References

Cook T, Nolan JP, Gupta KJ, Gabbott DA. The Airway Management Device (AMD) is not ‘reliable and safe’. Anaesthesia 2002; 57: 291.Google Scholar
Mandal NG. A new device has to be safe and reliable too. Anaesthesia 2001; 56: 382–383.Google Scholar
Chiu CL, Wang CY. An evaluation of the modified Airway Management Device. Anaesth Intens Care 2004; 32: 77–80.Google Scholar
Cook TM, Porter MV. Randomized comparison of the Classic Laryngeal Mask Airway with the Airway Management Device during anaesthesia. Br J Anaesth 2003; 91: 672–677.Google Scholar
von Goedecke A, Brimacombe J, Hormann C et al. Pressure support ventilation versus continuous positive airway pressure ventilation with the ProSeal laryngeal mask airway: a randomized crossover study of anesthetized pediatric patients. Anesth Analg 2005; 100: 357–360.Google Scholar
Maltby JR, Beriault MT, Watson NC et al. LMA-Classic and LMA-ProSeal are effective alternatives to endotracheal intubation for gynecologic laparoscopy. Can J Anaesth 2003; 50: 71–77.Google Scholar
Roth H, Genzwuerker HV, Rothhaas A et al. The ProSeal laryngeal mask airway and the laryngeal tube suction for ventilation in gynaecological patients undergoing laparoscopic surgery. Eur J Anaesthesiol 2005; 22: 117–122.Google Scholar
Mallampati SR, Gatt SP, Gugino LD et al. A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J 1985; 32: 429–434.Google Scholar
Biosil Ltd. AMD Airway Management Device. Glasgow: Product Information leaflet, 2002.
Tan SM, Sim YY, Koay CK. The ProSeal laryngeal mask airway size selection in male and patients in an Asian population. Anaesth Intensive Care 2005; 33: 239–242.Google Scholar
Sivasankar R, Bahlmann UB, Stacey MR et al. An evaluation of the modified Airway Management Device. Anaesthesia 2003; 58: 558–561.Google Scholar
Karasawa F, Hamachi T, Takamatsu I, Oshima T. Time required to achieve a stable cuff pressure by repeated aspiration of the cuff during anaesthesia with nitrous oxide. Eur J Anaesthesiol 2003; 20: 470–474.Google Scholar