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Excerpt
Materials and Methods: After approval of the local ethics committee and written consent of the guardians, 100 ASA I/II patients, 2 to 8 years, scheduled for elective ambulatory interventions were randomized to be ventilated with LMA or Aura. Following standardized induction of general anaesthesia, the completely deflated airway devices were placed according to manufacturer's instructions. Cuffs were inflated with 10 ml for size 2, 14 ml for size 2.5 and 20 ml for size 3. Number of attempts (maximum 2), time until first tidal volume, initial cuff pressure and intraoperative tidal volumes (goal: petCO2 of 35 mmHg) were recorded. Cuff pressures were adjusted to 60 cmH2O for measurement of airway leak pressure. Devices were inspected for traces of blood after removal. Patients were questioned for postoperative complaints.
Results and Discussions: 50 patients were ventilated with either device. Average age was 5.1 (2.2-8.0) for LMA and 5.1 (2.5-7.9) years for Aura. 44 patients in the LMA group and 48 patients in the Aura group were male. Weight, height, baseline heart rate, blood pressure and oxygen saturation were comparable for both groups. Size 2 was used in LMA/Aura in 7/4, size 2.5 in 41/45 and size 3 in 2/1 patients. Insertion was successful in all patients (first attempt LMA 45, Aura 47). Time until first tidal volume for LMA and Aura was 8.7 ± 2.3 and 8.0 ± 2.3 seconds. Initial cuff pressures were 104.2 ± 19.0cmH2O for LMA and 74.4 ± 24.3cmH2O for Aura (p < 0.001). Tidal volumes were 8.7 and 9.1 ml kg−1 for LMA and Aura, airway leak pressures were 32.7 ± 9.4 and 34.1 ± 8.4cmH2O. Intraoperative dislocation occurred in 1 LMA patient. No traces of blood were found after removal of the devices. No postoperative complaints were stated.
Conclusion(s): In paediatric patients, LMA-Classic and Ambu AuraOnce are found to be comparable in all respects except cuff pressures resulting from recommended inflation volumes. Excess of maximum recommended cuff pressure is considerably higher with LMA-Classic.
