Anesthésie et recherche clinique
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Prolonged Use of the Laryngeal Mask Airway ProSeal™: A Report of Seven Cases Lasting 5-11 h

Berthold Moser, Joseph Brimacombe, Bimla Sharma, Amitabh Dutta, Jayashree Sood, Ved P Kumra and Christian Keller

Background: There is controversy concerning use of laryngeal mask airway devices for procedures lasting more than 2 h. The LMA ProSealTM is a laryngeal mask device with a modified cuff to facilitate ventilation and a drain tube to provide airway protection that is better suited for prolonged use than the LMA ClassicTM.

Objectives: We aimed to describe the successful use of the LMA ProSealTM in seven patients in a variety of clinical situations for procedures lasting more than 5 h and provide practical guidelines about its use in this situation.

Results: The cases illustrate the use of the LMA ProSealTM in a variety of clinical situations (supine and prone position) and for a variety of prolonged procedures: as a planned airway device and as an airway rescue device. LMA ProSealTM forms an effective seal with the respiratory tract (10 cm H2O higher) and is therefore suited as ventilator device. It also forms an effective seal with the gastrointestinal tract (30 cm H2O higher), provides protection against aspiration and gastric insufflation and provides easy access to the gastrointestinal tract allowing the passage of a gastric tube reducing again the risk of aspiration.

Conclusion: The use of the LMA ProSealTM for prolonged procedures is feasible. In principle, it should be safer and more effective than the LMA ClassicTM.