ProSeal-LM, a modification of the laryngeal mask:: Description and the first clinical results

The ProSeal-LMA is a modification of the laryngeal mask airway (LMA) invented by AlJ Brain. It differs from the known models in three major respects: An additional lumen extending into the tip of the cuff allows insertion of a gastric tube. A pocket immediately behind the cuff accomodates a finger or a siliconated metal introducer and thus facilitates insertion. An additional cuff at the dorsal aspect of the mask pushes the mask into a ventral direction and thus improves the seal around the glottic opening. Our experience after 8 months of clinical use and first data from an international multi-center-study (24 ProSeal-LMA/24 Standard-LMA) are reported. With a ProSeal-LMA insertion of a gastric tube is much easier and more reliable than with a Standard-LMA (24/24 patients vs. 2/24 patients). Judged from visibility of the oesophagus during fibre-endoscopy the position of the ProSeal-LMA is superior to that of the Standard-LMA. Both are equally well tolerated and handled. Most remarkable is a better seal for the ProSeal-LMA (pressure for a leak of 3 L/min: 31 mbar compared to 20 mbar (mean) for the Standard-LMA). Therefore the ProSeal-LMA seems suitable for anaesthesia procedures with IPPV, which up to now are a domain of endotracheal intubation.