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GENERAL ARTICLES

The ProSeal^TM Has a Shorter Life-Span than the Classic^TM Laryngeal Mask Airway

Sarah Doneley, MB BS^*, Joseph Brimacombe, MB ChB, FRCA, MD, Christian Keller, MD, and Achim von Goedecke, MD

*Department of Anaesthesia and Intensive Care, Cairns Base Hospital, Australia; James Cook University, Department of Anaesthesia and Intensive Care, Cairns Base Hospital, Australia; Department of Anaesthesia and Intensive Care Medicine, Leopold-Franzens University, Innsbruck, Austria

We tested the hypothesis that the life-span of the ProSeal^TM laryngeal mask airway (LMA) is shorter than the Classic^TM LMA. We also compared residual cuff volumes and changes in elastance and permeability with use. Six new size 4 ProSeal^TM LMAs and 6 new size 4 Classic^TM LMAs were tested. Each LMA underwent a simulated clinical use cycle until it failed the pre-use check tests. The simulated clinical use cycle comprised: i) inflating the cuff to the maximum recommended volume for 1 h; ii) immersion in an enzymatic solution for 3 min; iii) washing the external and internal surfaces; iv) automatic washing for 14 min (85°C); v) drying for 30 min (75°C); and vi) autoclaving at 134°C for 4 min at 206 kPa. Before the first cycle and every 10 subsequent cycles, the cuff was inflated with 40 mL air and the intracuff pressure was measured immediately and 3 h later. The initial intracuff pressure was taken to be an inverse measure of the elastance or resistance to deformation, and the intracuff pressure change were taken as a measure of the permeability. The residual cuff volume was determined for 10 Classic^TM and 10 ProSeal^TM size 4 LMAs using a gas dilution technique. The mean ± sd (range) longevity for the ProSeal^TM LMA and Classic^TM LMA was 82 ± 23 (45–109) uses and 133 ± 35 (76–176) uses, respectively. The ProSeal^TM LMA has a shorter life-span than the Classic^TM LMA (P = 0.01). For the ProSeal^TM LMA, there was no change in elastance or permeability with use. For the Classic^TM LMA, there was a decrease in elastance (P < 0.0001) and an increase in permeability (P < 0.0001) with use. The residual cuff volume was higher for the ProSeal^TM LMA (2.6 ± 1.3 mL versus 1.5 ± 0.9, P = 0.04). We conclude that the life-span of the ProSeal^TM LMA is shorter than the Classic^TM LMA, but both exceed the manufacturer’s recommendations of 40 uses. We recommend that reusable LMA devices be discarded when they fail the pre-use check tests, rather than after a specific number of uses.

This article has been cited by other articles:

				T. M. Cook Editorial I: The classic laryngeal mask airway: a tried and tested airway. What now? Br. J. Anaesth., February 1, 2006; 96(2): 149 - 152. [Full Text] [PDF]