Doneley, Sarah, Brimacombe, Joseph , Keller, Christian , and von Goedecke, Achim (2005) The ProSeal has a shorter life-span than the classic laryngeal mask airway. Anesthesia and Analgesia, 100. pp. 590-593.

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Abstract

We tested the hypothesis that the life-span of the ProSealTM laryngeal mask airway (LMA) is shorter than the ClassicTM LMA. We also compared residual cuff volumes and changes in elastance and permeability with use. Six new size 4 ProSealTM LMAs and 6 new size 4 ClassicTM LMAs were tested. Each LMA underwent a simulated clinical use cycle until it failed the pre-use check tests. The simulated clinical use cycle comprised: i) inflating the cuff to the maximum recommended volume for 1 h; ii) immersion in an enzymatic solution for 3 min; iii) washing the external and internal surfaces; iv) automatic washing for 14 min (85°C); v) drying for 30 min (75°C); and vi) autoclaving at 134°C for 4 min at 206 kPa. Before the first cycle and every 10 subsequent cycles, the cuff was inflated with 40 mL air and the intracuff pressure was measured immediately and 3 h later. The initial intracuff pressure was taken to be an inverse measure of the elastance or resistance to deformation, and the intracuff pressure change were taken as a measure of the permeability. The residual cuff volume was determined for 10 ClassicTM and 10 ProSealTM size 4 LMAs using a gas dilution technique. The mean ± sd (range) longevity for the ProSealTM LMA and ClassicTM LMA was 82 ± 23 (45–109) uses and 133 ± 35 (76–176) uses, respectively. The ProSealTM LMA has a shorter life-span than the ClassicTM LMA (P = 0.01). For the ProSealTM LMA, there was no change in elastance or permeability with use. For the ClassicTM LMA, there was a decrease in elastance (P < 0.0001) and an increase in permeability (P < 0.0001) with use. The residual cuff volume was higher for the ProSealTM LMA (2.6 ± 1.3 mL versus 1.5 ± 0.9, P = 0.04). We conclude that the life-span of the ProSealTM LMA is shorter than the ClassicTM LMA, but both exceed the manufacturer’s recommendations of 40 uses. We recommend that reusable LMA devices be discarded when they fail the pre-use check tests, rather than after a specific number of uses.

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