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Research article
Narut Ruananukun
Mahidol University Faculty of Medicine Ramathibodi Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7770-4813
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This work is licensed under a CC BY 4.0 License. Read Full License
Background : Hyperinflation of laryngeal mask cuffs may carry the risk of airway complications. The manufacturer recommends inflating cuff until the intracuff pressure reaches 60 cmH 2 O, or inflate with the volume of air to not exceed the maximum recommended volume. We prospectively assessed the correlation of cuff inflating volumes and pressures, and the appropriated the cuff inflating volumes to generate an intracuff pressure of 60 cmH 2 O in the adult laryngeal masks from different manufacturers. Methods : Two groups of eighty patients requiring laryngeal mask size 3 and 4 during general anesthesia were randomized into 4 subgroups for each size of the laryngeal mask: Soft Seal ® (Portex ® ), AuraOnce TM (Ambu ® ), LMA-Classic TM (Teleflex ® ) and LMA-ProSeal TM (Teleflex ® ). After insertion, the cuff was inflated with 5-ml increments of air up to the maximum recommended volume. After each 5-ml intracuff pressure was measured, the volume of air that generated the intracuff pressure of 60 cmH 2 O was recorded . Results : Mean(SD) volume of air required to achieve the intracuff pressure of 60 cmH 2 O in Soft Seal ® , AuraOnce TM , LMA-Classic TM , LMA-ProSeal TM laryngeal mask size 3 were 11.80(1.88), 9.20(1.88), 8.95(1.50) and 13.50(2.48) ml, respectively, and these volumes in laryngeal mask size 4 were 14.45(4.12), 12.55(1.85), 11.30(1.95) and 18.20(3.47) ml, respectively. The maximum recommended volume resulted in high intracuff pressures (>60 cmH 2 O) in all laryngeal mask types and sizes studied. Conclusion : Pressure-volume curves of adult laryngeal masks are all in sigmoidal shape. Cuff designs and materials can effect pressure and volume correlation. Approximately half of the maximum recommended volume is required to achieve the intracuff pressure of 60 cmH 2 O except LMA-ProSeal TM which required two-thirds of the maximum recommended volume. Trial registration: Thai Clinical Trials Registry, TCTR20150602001, May 28, 2015
Keywords
laryngeal mask, cuff inflating volume, intracuff pressure
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CURRENT STATUS: Published
View the published article at BMC Anesthesiology.
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Submission checks complete
On 27 Apr, 2020
Editorial decision: Accept
On 27 Apr, 2020
Version 2
Posted 11 Oct, 2019
No comments provided
Editorial decision: Minor revision
On 20 Apr, 2020
Review #1 received
Received 22 Jan, 2020
Reviewers invited
Invitations sent on 06 Nov, 2019
Reviewer #1 agreed
On 06 Nov, 2019
Editor assigned
On 10 Oct, 2019
Submission checks complete
On 09 Oct, 2019
Editor invited
On 09 Oct, 2019
No comments provided
Editorial decision: Major revision
On 05 Jun, 2019
Review #1 received
Received 20 Mar, 2019
Review #2 received
Received 20 Mar, 2019
Reviewer #2 agreed
On 10 Mar, 2019
Reviewer #1 agreed
On 08 Mar, 2019
Reviewers invited
Invitations sent on 05 Mar, 2019
Editor assigned
On 12 Feb, 2019
Submission checks complete
On 05 Feb, 2019
Editor invited
On 05 Feb, 2019
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Subject Areas
Internal Medicine Specialties
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See the published version of this preprint at BMC Anesthesiology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Narut Ruananukun
Mahidol University Faculty of Medicine Ramathibodi Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7770-4813
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Anesthesiology.
No community comments so far
Submission checks complete
On 27 Apr, 2020
Editorial decision: Accept
On 27 Apr, 2020
Version 2
Posted 11 Oct, 2019
No comments provided
Editorial decision: Minor revision
On 20 Apr, 2020
Review #1 received
Received 22 Jan, 2020
Reviewers invited
Invitations sent on 06 Nov, 2019
Reviewer #1 agreed
On 06 Nov, 2019
Editor assigned
On 10 Oct, 2019
Submission checks complete
On 09 Oct, 2019
Editor invited
On 09 Oct, 2019
No comments provided
Editorial decision: Major revision
On 05 Jun, 2019
Review #1 received
Received 20 Mar, 2019
Review #2 received
Received 20 Mar, 2019
Reviewer #2 agreed
On 10 Mar, 2019
Reviewer #1 agreed
On 08 Mar, 2019
Reviewers invited
Invitations sent on 05 Mar, 2019
Editor assigned
On 12 Feb, 2019
Submission checks complete
On 05 Feb, 2019
Editor invited
On 05 Feb, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Internal Medicine Specialties
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Anesthesiology.
Background : Hyperinflation of laryngeal mask cuffs may carry the risk of airway complications. The manufacturer recommends inflating cuff until the intracuff pressure reaches 60 cmH 2 O, or inflate with the volume of air to not exceed the maximum recommended volume. We prospectively assessed the correlation of cuff inflating volumes and pressures, and the appropriated the cuff inflating volumes to generate an intracuff pressure of 60 cmH 2 O in the adult laryngeal masks from different manufacturers. Methods : Two groups of eighty patients requiring laryngeal mask size 3 and 4 during general anesthesia were randomized into 4 subgroups for each size of the laryngeal mask: Soft Seal ® (Portex ® ), AuraOnce TM (Ambu ® ), LMA-Classic TM (Teleflex ® ) and LMA-ProSeal TM (Teleflex ® ). After insertion, the cuff was inflated with 5-ml increments of air up to the maximum recommended volume. After each 5-ml intracuff pressure was measured, the volume of air that generated the intracuff pressure of 60 cmH 2 O was recorded . Results : Mean(SD) volume of air required to achieve the intracuff pressure of 60 cmH 2 O in Soft Seal ® , AuraOnce TM , LMA-Classic TM , LMA-ProSeal TM laryngeal mask size 3 were 11.80(1.88), 9.20(1.88), 8.95(1.50) and 13.50(2.48) ml, respectively, and these volumes in laryngeal mask size 4 were 14.45(4.12), 12.55(1.85), 11.30(1.95) and 18.20(3.47) ml, respectively. The maximum recommended volume resulted in high intracuff pressures (>60 cmH 2 O) in all laryngeal mask types and sizes studied. Conclusion : Pressure-volume curves of adult laryngeal masks are all in sigmoidal shape. Cuff designs and materials can effect pressure and volume correlation. Approximately half of the maximum recommended volume is required to achieve the intracuff pressure of 60 cmH 2 O except LMA-ProSeal TM which required two-thirds of the maximum recommended volume. Trial registration: Thai Clinical Trials Registry, TCTR20150602001, May 28, 2015
Figure 1
Figure 2
Figure 3
Figure 4
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