Clinical assessment of the single use laryngeal mask airway - the LMA-Unique

We conducted a clinical comparison of the laryngeal mask airway (LMA) and the new single use PVC LMA (LMA-Unique) in 100 fasted adult patients undergoing elective surgery. Patients were allocated to one of two groups: group 1 (n=50) was managed by two consultants and group 2 by two trainee anaesthetists. Airway management was randomized prospectively within each group, and cuff pressure in both devices was maintained at a maximum of 50 mm Hg with upward size substitution if leaks persisted during intermittent positive pressure ventilation (IPPV). Insertion with the recommended technique was successful in all patients (85 first attempt). One patient (group 1) required four attempts for insertion of the LMA-Unique and in one patient (group 2) the LMA-Unique was replaced by a tracheal tube because of persistent leaks during IPPV. In 99 patients IPPV was uneventful. The adjusted mean volume of air for cuff inflation in the LMA-Unique was significantly less in group 1 (P=0.0013). At fibreoptic laryngoscopic examination, the vocal cords or arytenoids, or both, could be seen in 92% of patients in group 1 and in 90% of patients in group 2. Immediate throat soreness was reported in four-patients in group 1 and in seven in group 2. The results suggest that the LMA-Unique was similar in clinical performance to the LMA.