Related factors for ProSeal™ laryngeal mask airway failure

Abstract

Introduction: The laryngeal mask airway (LMA) is a device for airway management that is easy to insert, safe, and efficient. However, there are associated complications that can lead to important patient morbidity and mortality, as ventilator failure, can occur with reported incidence between 0.2% and 4.7%. Male gender, advanced age, obesity, short thyromental distance, and poor dentition are known related factors to LMA failure. Objective: Determine the incidence of ProSeal™ LMA ventilatory failure and identify clinical related conditions. Materials and methods: Observational analytic study a group of adult patients with ProSeal™ laryngeal mask for airway management. Statistical analysis was performed using STATA 12.1 software. Bivariate analysis was done using Fisher's exact test or Chi2 as it corresponded with statistical significance defined as P value <0.05. Skewed logistic regression for multivariate analysis was performed for estimating adjusted odd ratios (ORs). Results: Incidence of ProSeal™ LMA ventilatory failure was 5.2%. In the group of patients that presented failure, 69 were older than 75 years (OR = 1.06, 95% confidence interval [CI] 1.03-1.09, P < 0.001), 6 (23.1%) thyromental distance less than 6 cm (OR = 2.48, 95% CI 0.93-6.62, P = 0.069), 5 (19.2%), inadequate anesthetic depth and/or laryngospasm (OR = 5.78, 95% CI 2.23-14.96, P < 0.001) and 9 (34.6%) vintraoperative use of neuromuscular blockers (NMB) (OR = 2.35, 95% CI 1.06-5.21, P = 0.035). Conclusion: In patients with LMA management, the age, intraoperative use of NMB and inadequate anesthetic depth and/or laryngospasm are clinical related conditions for ProSeal™ LMA ventilatory failure.