Cuff Volume of Laryngeal Mask Airway ProSealTM in Korean Adults / 대한마취과학회지

ABSTRACT

BACKGROUND: The purpose of this study was to determine the cuff volume of the laryngeal mask airway ProSeal(TM)(PLMA (TM)) in Korean adults, which was measured at an intracuff pressure of 60 cmH2O. METHODS: A size 3 PLMATM was used for females (n = 57) and a size 4 PLMATM for males (n = 45). Anesthesia was induced with thiopental and rocuronium and maintained with sevoflurane, nitrous oxide and oxygen. After 5 minutes of conventional mask ventilation, the PLMATM was inserted using an the index finger in one motion. Increments of air up to a final intracuff pressure of 60 cmH2O were introduced and the patency of the airway was confirmed. Following successful placement during ventilation, the intracuff pressure was maintained at 60 cmH2O during anesthesia. The volume of air required to inflate the cuff to this pressure was measured, first after successful insertion of the mask (CV ins), and then 10 minutes before the end of anesthesia (CV end). Each patient was asked whether they had a sore throat, just before leaving the postanesthesia care unit (PACU) and again 24h after surgery. Data is presented as means standard error of mean (SEM). Statistical analysis was performed by bivariate correlation analysis, and by the paired t-test. Significance was accepted when P < 0.05. RESULTS: CV ins was 15-26 ml (22.8+/-0.3 ml)(female), 23-45 ml (33.6+/-0.6 ml)(male) and CV end was 17-27 ml (23.2+/-0.3 ml)(female), 22 45 ml (33.8+/-0.7 ml)(male). There were no significant correlation between BMI (body mass index), thyromental distance, sternomental distance and cuff volume (CV ins). In males, there was no significant difference between CV ins and CV end, but, in females, there was a significant difference between CV ins and CV end (CV ins < CV end)(P < 0.05). Incidences of postoperative sore throat just before leaving the PACU were 22.8% in females, 15.6% in males, and 24 hrs after surgery, these were 7% in females, 4.4% in males. CONCLUSIONS: We conclude that CV ins in both male and female was widely variable and that there is no correlation between anatomical variation and inflated cuff volume. Moreover, we could not prevent postopertative sore throat by changing cuff volume at an intracuff pressure of 60 cmH2O. Especially in Korean females, the cuff volume required to inflate the cuff to 60 cmH2O increased with anesthesia.