The aim of this randomized prospective study is to compare two laryngeal mask airways with a provision for evacuation of gastric contents, the LMA Proseal and The investigators hypothesize that airway leak pressures with the LMA Proseal will be significantly different (higher) when compared with the LMA Supreme.
The goal of this study is to compare the LMA Proseal and LMA Supreme in children having surgery. The investigators hypothesize that the airway leak pressures with the LMA Proseal will be superior to the LMA Supreme. Airway leak pressures will be measured by recording the circuit pressure at which equilibrium is reached. The ease of placement of the device and gastric tube, fiberoptic grade of laryngeal view, feasibility of use during positive pressure ventilation, and complications (airway related, gastric insufflation, trauma) will also be assessed.
Study Type
OBSERVATIONAL
Enrollment
60
LMA Proseal will be placed in children weighing 10-20kg based on a computer generated randomization
LMA Supreme will be placed in children weighing 10-20kg based on a computer generated randomization
Childrens Memorial Hospital
Chicago, Illinois, United States
Airway Leak Pressure
Airway leak pressures will be measured by recording the circuit pressure at which equilibrium is reached when fresh gas flow is delivered at 3L/min when the pressure limiting valve is closed completely.
Time frame: participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours
Time to secure the airway
From picking up the airway device to bilateral chest expansion and presence of ETCO2
Time frame: participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours
Number of attempts to place the device
number of attempts needed for successful placement will be recorded (maximum of 3 attempts will be considered as a failure)
Time frame: participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours
Fiberoptic grade of laryngeal view
The laryngeal alignment through the devices will be graded using an established scoring system
Time frame: participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours
Gastric insufflation
The presence of gastric insufflations will be assessed during leak pressure testing by using epigastric auscultation
Time frame: participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours
Ease of gastric tube placement
The ease of gastric placement will be timed and assessed using a subjective scale
Time frame: participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours
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Fiberoptic view through the gastric tube
The view through the gastric drain tube of the LMA supreme will be assessed and graded using an established scoring system
Time frame: participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours
feasibility of positive pressure ventilation
Peak inspiratory pressure and tidal volumes will be recorded. Maximum peak inspiratory pressure will be the airway leak pressure was determined for each patient
Time frame: participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours
Quality of the airway
The quality of hands free anesthesia will be assessed during maintenance of anesthesia using a previously described scale
Time frame: participants will be followed for the duration of anesthesia and after surgery, an expected average of 12 hours
Adverse effects
complications such as oxygen desaturations, mucosal trauma, reflex activation of the airway, sore throat, dysphonia will be recorded
Time frame: Participants will be followed for the duration of anesthesia and 24 hours postoperatively