Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Anesthesiology
Published in: BMC Anesthesiology 1/2015

Open Access 01-12-2015 | Research article

Comparisons of clinical performance of guardian laryngeal mask with laryngeal mask airway ProSeal

Authors: Ajay Kumar Pajiyar, Zhiting Wen, Haiyun Wang, Lin Ma, Lumin Miao, Guolin Wang

Published in: BMC Anesthesiology | Issue 1/2015

Login to get access

Abstract

Background

The Guardian Laryngeal Mask Airway (G-LMA) is a new silicone-based single-use extraglottic device with the drainage port and a cuff pilot valve with pressure indicator. The aim of this study is to compare the clinical performance of this laryngeal mask airway with ProSeal laryngeal mask airway (P-LMA).

Methods

In this prospective randomized study, we included adult patients with ASA grading I and II scheduled for elective surgery requiring supine position under total intravenous anesthesia. The patients were randomly allocated to two groups, 40 in each. G-LMA and P-LMA were used in groups G and P respectively. The cuff of each device was air inflated to 60 cmH2O. The primary outcome was to compare the airway sealing pressure and the secondary outcome was to compare the efficacy and safety of these two devices with respect to insertion success, insertion time, ease of insertion, volume of air for cuff inflation to 60 cmH2O, intracuff pressure measurement, gastric tube insertion attempt, gastric tube insertion time, Fiberoptic laryngeal view, and postoperative pharyngolaryngeal morbidity.

Results

The airway sealing pressure at 60cmH2O cuff pressure was significantly greater in G-LMA than P-LMA (p = 0.04).The first successful attempt of both groups were comparable (p = 1.000). Insertion time was significantly shorter in G-LMA than P-LMA (p < 0.0001). The first successful attempt for the gastric tube insertion in both groups was comparable (p = 0.431). Gastric tube insertion time was less in G-LMA than in P-LMA (p < 0.0001). The volume of air for cuff inflation to 60 cmH2O was more in G-LMA than in P-LMA (<0.0001). The intracuff pressure measurement at 30, 60, 90 and 120 minutes were comparable (p = 0.823, 0.182, 0.870, 0.658).We did not find differences in ease of insertion (p = 0.60); Fiber-optic positions of airway devices were comparable (p = 0.83). In addition, blood staining (p = 1.00), sore throat and dysphagia at 1, 2 and 24 hour (p = 1.00) were comparable in both groups.

Conclusion

The Guardian laryngeal mask airway was associated with high airway sealing pressure with a quicker insertion of the device as well as gastric tube.

Trial registration

Clinical Trial.gov Identifier: NCT02063516. Date: June 2013
Appendix
Available only for authorised users
Literature
1.
Tiefenthaler W, Eschertzhuber S, Brimacombe J, Fricke E, Keller C, Kaufmann M. A randomised, non-crossover study of the GuardianCPV laryngeal Mask versus the LMA Supreme in paralysed, anaesthetised female patients. Anaesthesia. 2013;68(6):600–4.CrossRefPubMed
2.
Brimacombe J, Keller C. The ProSeal laryngeal mask airway: a randomized, crossover study with the standard laryngeal mask airway in paralyzed, anesthetized patients. Anesthesiology. 2000;93(1):104–9.CrossRefPubMed
3.
Cook TM, Nolan JP, Verghese C, Strube PJ, Lees M, Millar JM, et al. Randomized crossover comparison of the proseal with the classic laryngeal mask airway in unparalysed anaesthetized patients. Br J Anaesth. 2002;88(4):527–33.CrossRefPubMed
4.
Galgon RE, Schroeder KM, Han S, Andrei A, Joffe AM. The air-Q((R)) intubating laryngeal airway vs the LMA-ProSeal(TM): a prospective, randomised trial of airway seal pressure. Anaesthesia. 2011;66(12):1093–100.CrossRefPubMedPubMedCentral
5.
Williams DL, Zeng JM, Alexander KD, Andrews DT. Randomised Comparison of the AMBU AuraOnce Laryngeal Mask and the LMA Unique Laryngeal Mask Airway in Spontaneously Breathing Adults. Anesthesiol Res Pract. 2012;2012:405812.PubMedPubMedCentral
6.
Russo SG, Cremer S, Eich C, Jipp M, Cohnen J, Strack M, et al. Magnetic resonance imaging study of the in vivo position of the extraglottic airway devices i-gel and LMA-Supreme in anaesthetized human volunteers. Br J Anaesth. 2012;109(6):996–1004.CrossRefPubMed
7.
Chauhan G, Nayar P, Seth A, Gupta K, Panwar M, Agrawal N. Comparison of clinical performance of the I-gel with LMA proseal. J Anaesthesiol Clin Pharmacol. 2013;29(1):56–60.CrossRefPubMedPubMedCentral
8.
Keller C, Brimacombe JR, Keller K, Morris R. Comparison of four methods for assessing airway sealing pressure with the laryngeal mask airway in adult patients. Br J Anaesth. 1999;82(2):286–7.CrossRefPubMed
9.
Brimacomb J, Keller C, Kurian S, Myles J. Reliability of epigastric auscultation to detect gastric insufflation. Br J Anaesth. 2002;88(1):127–9.CrossRefPubMed
10.
Brimacombe J, Holyoake L, Keller C, Brimacombe N, Scully M, Barry J, et al. Pharyngolaryngeal, neck, and jaw discomfort after anesthesia with the face mask and laryngeal mask airway at high and low cuff volumes in males and females. Anesthesiology. 2000;93(1):26–31.CrossRefPubMed
11.
Verghese C, Ramaswamy B. LMA-SupremeTM—a new single-use LMATM with gastric access: a report on its clinical efficacy. Br J Anaesth. 2008;101(3):405–10.CrossRefPubMed
12.
Hosten T, Gurkan Y, Ozdamar D, Tekin M, Toker K, Solak M. A new supraglottic airway device: LMA-supreme, comparison with LMA-Proseal. Acta Anaesthesiol Scand. 2009;53(7):852–7.CrossRefPubMed
13.
Seet E, Rajeev S, Firoz T, Yousaf F, Wong J, Wong DT, et al. Safety and efficacy of laryngeal mask airway Supreme versus laryngeal mask airway ProSeal: a randomized controlled trial. Eur J Anaesthesiol. 2010;27(7):602–7.CrossRefPubMed
14.
Eschertzhuber S, Brimacombe J, Hohlrieder M, Keller C. The laryngeal mask airway Supreme--a single use laryngeal mask airway with an oesophageal vent. A randomised, cross-over study with the laryngeal mask airway ProSeal in paralysed, anaesthetised patients. Anaesthesia. 2009;64(1):79–83.CrossRefPubMed
15.
Hosten T, Yildiz TS, Kus A, Solak M, Toker K. Comparison of Supreme Laryngeal Mask Airway and ProSeal Laryngeal Mask Airway during Cholecystectomy. Balkan Med J. 2012;29(3):314–9.PubMedPubMedCentral
16.
Brain AI, Verghese C, Strube PJ. The LMA ‘ProSeal’–a laryngeal mask with an oesophageal vent. Br J Anaesth. 2000;84(5):650–4.CrossRefPubMed
17.
Brimacombe J, Keller C, Puhringer F. Pharyngeal mucosal pressure and perfusion: a fiberoptic evaluation of the posterior pharynx in anesthetized adult patients with a modified cuffed oropharyngeal airway. Anesthesiology. 1999;91(6):1661–5.CrossRefPubMed
18.
Wong JG, Heaney M, Chambers NA, Erb TO, von Ungern-Sternberg BS. Impact of laryngeal mask airway cuff pressures on the incidence of sore throat in children. Paediatr Anaesth. 2009;19(5):464–9.CrossRefPubMed
19.
20.
Nott MR, Noble PD, Parmar M. Reducing the incidence of sore throat with the laryngeal mask airway. Eur J Anaesthesiol. 1998;15(2):153–7.CrossRefPubMed
21.
Seet E, Yousaf F, Gupta S, Subramanyam R, Wong DT, Chung F. Use of manometry for laryngeal mask airway reduces postoperative pharyngolaryngeal adverse events: a prospective, randomized trial. Anesthesiology. 2010;112(3):652–7.CrossRefPubMed
Metadata
Title
Comparisons of clinical performance of guardian laryngeal mask with laryngeal mask airway ProSeal
Authors
Ajay Kumar Pajiyar
Zhiting Wen
Haiyun Wang
Lin Ma
Lumin Miao
Guolin Wang
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2015
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-015-0039-3

Other articles of this Issue 1/2015

BMC Anesthesiology 1/2015 Go to the issue

Research article

Adequate sedation with single-dose dexmedetomidine in patients undergoing transurethral resection of the prostate with spinal anaesthesia: a dose–response study by age group

Research article

Ventilation by mask before and after the administration of neuromuscular blockade: a pragmatic non-inferiority trial

Research article

Dynamics of heart rate variability in patients with type 2 diabetes mellitus during spinal anaesthesia: prospective observational study

Research article

The effect of preoperative suggestions on perioperative dreams and dream recalls after administration of different general anesthetic combinations: a randomized trial in maxillofacial surgery

Research article

Temperature control in critically ill patients with a novel esophageal cooling device: a case series

Research article

Remifentanil added to sufentanil-sevoflurane anesthesia suppresses hemodynamic and metabolic stress responses to intense surgical stimuli more effectively than high-dose sufentanil-sevoflurane alone