ProSeal laryngeal mask airway in 120 pediatric surgical patients: a prospective evaluation of characteristics and performance

BACKGROUND: The ProSeal LMA (PLMA) has recently been introduced in pediatric sizes (1.5, 2, 2.5, 3). Limited pediatric data have been published. METHODS: After Institutional Review Board (IRB) approval, the PLMA was placed in 120 children aged 4 months to 13 years (5-50 kg). The following data were collected prospectively: induction agent, number of placement attempts (limited to three), placement success or failure, PLMA size, leak pressure, ventilatory pattern spontaneous (SV) or controlled positive pressure ventilation (PPV)], success or failure of gastric suction tube placement, hypoxemia, dislodgement, laryngospasm, bronchospasm, aspiration, and traumatic placement. RESULTS: The PLMA was easily placed in children with a higher first attempt success rate (94%) than reported for adults. Overall PLMA and gastric tube placement were both 100% successful. Leak pressures were similar to those reported for the PLMA in adults and higher than reported for the Classic LMA in children. No bronchospasm, laryngospasm, hypoxemia, dislodgement, or aspiration occurred. CONCLUSIONS: Although the PLMA can be used with SV or PPV, the higher leak pressure achieved with the PLMA, and the ability to evacuate fluid and air from the stomach suggest that it may be a useful alternative to tracheal intubation for procedures in which PPV is desired in children aged 4 months to 13 years.