ProSeal laryngeal mask protects against aspiration of fluid in the pharynx

Abstract

Background. The ProSeal laryngeal mask airway (PLMA) is a new device designed to isolate the airway from the digestive tract. Methods. We studied the ability of the PLMA to isolate the airway in 103 anaesthetized adults who were breathing spontaneously or given neuromuscular blocking agents, by filling the hypopharynx with methylene blue-dyed saline introduced down the drainage tube once the mask was in place. At the beginning and end of the procedure, a fibre-optic bronchoscope was passed down the airway tube to observe any dyed saline in the bowl of the mask. Results. The PLMA was positioned correctly in all successful attempts (102 out of 103 attempts) and was able to isolate the glottis from fluid in the hypopharynx in all patients initially. Leakage of saline into the bowl of the mask occurred in two patients in whom displacement of the mask was caused by upper airway events during the procedure. In the remaining 100 patients, the glottis was isolated successfully for the duration of the procedure. Conclusions. The PLMA can be positioned reliably. It can isolate the airway from fluid in the hypopharynx.