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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2020

Open Access 01-12-2020 | Dysphonia | Research article

Clinical performance of the LMA Protector™ airway in moderately obese patients

Authors: Ina Ismiarti Shariffuddin, Sook Hui Chaw, Ling Wei Ng, Ching Hooi Lim, Mohd Fitry Zainal Abidin, Wan A. Wan Zakaria, Wendy H. Teoh

Published in: BMC Anesthesiology | Issue 1/2020

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Abstract

Background

The 4th National Audit Project of The Royal College of Anaesthetists and The Difficult Airway Society (NAP4) reported a higher incidence of supraglottic airway device (SAD) related pulmonary aspiration in obese patients especially with the first-generation SADs. The latest single-use SAD, the Protector™ provides a functional separation of the respiratory and digestive tracts and its laryngeal cuff with two ports allowing additional suction in tandem with the insertion of a gastric tube. The laryngeal cuff of LMA Protector™ allows a large catchment reservoir in the event of gastric content aspiration.

Methods

We evaluated the performance characteristics of the LMA Protector™ in 30 unparalysed, moderately obese patients. First attempt insertion rate, time for insertion, oropharyngeal leak pressure (OLP), and incidence of complications were recorded.

Results

We found high first and second attempt insertion rates of 28(93%) and 1(33%) respectively, with one failed attempt where no capnography trace could be detected, presumably from a downfolded device tip. The LMA Protector™ was inserted rapidly in 21.0(4.0) seconds and demonstrated high OLP of 31.8(5.4) cmH2O. Fibreoptic assessment showed a clear view of vocal cords in 93%. The incidence of blood staining on removal of device was 48%, postoperative sore throat 27%, dysphagia 10% and dysphonia 20% (all self-limiting, resolving a few hours postoperatively).

Conclusions

We conclude that the LMA Protector™ was associated with easy, expedient first attempt insertion success, demonstrating high oropharyngeal pressures and good anatomical position in the moderately obese population, with relatively low postoperative airway morbidity.

Trial registration

Australian New Zealand Clinical Trials Registry, ACTRN12617001152​314. Registered 7 August 2017.
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Metadata
Title
Clinical performance of the LMA Protector™ airway in moderately obese patients
Authors
Ina Ismiarti Shariffuddin
Sook Hui Chaw
Ling Wei Ng
Ching Hooi Lim
Mohd Fitry Zainal Abidin
Wan A. Wan Zakaria
Wendy H. Teoh
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2020
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-020-01100-z

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