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Performance of the PAX press vs the ProSeal laryngeal mask airway during general anesthesia

  • Alexandre Lallo
  • Pierre Drolet
  • Mélanie Lacroix
Reports of Original Investigations

Abstract

Purpose

The PAX press (PAX ) is a relatively new pharyngeal airway device that is easily inserted and effective in routine airway management. A prospective, randomized study was undertaken to compare the PAX with the ProSeal laryngeal mask airway (PLMA) during anesthesia with positive pressure ventilation.

Methods

One hundred adult patients scheduled for elective surgery under general anesthesia were randomized to airway management with either the PAX (n = 50) or the PLMA (n = 50). All patients swallowed a methylene blue capsule before anesthesia. After insertion, leak and inspiratory pressures were measured. Fibrescopy was used to view the glottis. Devices were inspected for blood or methylene blue staining upon removal at the end of surgery. An interview was conducted postoperatively to evaluate the occurrence of sore throat, dysphagia and dysphonia.

Results

Insertion time was longer for the PAx than for the PLMA (52 ± 44svs 34 ± 23 sec;P = 0.003). Leak pressure was lower while peak inspiratory pressures, and EtCO2 values were higher (P = 0.016; 0.027 and 0.04 respectively) with the PAx. Both devices provided comparable fibreoptic viewing of the glottis. There were no differences with respect to the incidence or pattern of blue stains upon removal. Blood was seen more often on the PAx (58%vs 19%) and dysphagia was also more frequent and severe with the PAX .

Conclusion

In comparison with the PLMA, PAX insertion time is longer and the ventilatory characteristics of this new device may be marginally inferior. The PAX is also more traumatic and is associated with more postoperative discomfort compared to the PLMA.

Keywords

Methylene Blue Laryngeal Mask Airway Airway Device Peak Airway Pressure Leak Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Efficacité du PAXpresset du masque laryngé ProSealdurant l’anesthésie générale

Résumé

Objectif

Le PAXpress (PAX ) est un dispositif pharyngé de contrôle des voies aériennes relativement nouveau; il s’insère facilement et est efficace dans la pratique de tous les jours. Une étude prospective et randomisée a été entreprise afin de comparer le PAX au masque laryngé ProSeal (PLMA) pendant une anesthésie avec ventilation à pression positive.

Méthodes

Cent patients adultes devant subir une chirurgie élective sous anesthésie générale ont été randomisés à l’une de deux stratégies de gestion des voies aériennes: le PAx (n = 50) ou le PLMA (n = 50). Tous les patients ont avalé une capsule de bleu de méthylène avant l’anesthésie. Après insertion, les pressions inspiratoires et de fuite ont été mesurées. Un fibroscope a été utilisé pour visualiser la glotte. Les dispositifs ont été inspectés pour détecter des taches de sang ou de bleu de méthylène lorsqu’on les a retirés à la fin de la chirurgie. Une entrevue postopératoire a été menée afin d’évaluer l’incidence de maux de gorge, de dysphagie et de dysphonie.

Résultats

Le temps d’insertion a été plus long pour le PaxTM que pour le PLMATM (52 ± 44s vs 34 ± 23 sec; P = 0,003). Les pressions de fuite étaient plus faibles et les pressions inspiratoires maximum et les valeurs de CO2 expiré (Et CO2) étaient plus élevées (P = 0,016; 0,027 et 0,04 respectivement) avec le PAx. Les deux appareils ont permis une visualisation comparable de la glotte par fibroscopie. Il n’y a pas eu de différence au niveau de l’incidence ou de la présence de taches bleues lors du retrait des dispositifs. Du sang était cependant plus fréquemment observé sur le PAx (58% vs 19%), de même qu’une dysphagie plus courante et sévère avec le PAx.

Conclusion

Comparé au PLMA, le temps d’insertion du PAx est plus long et les caractéristiques de ventilation de ce nouveau dispositif sont légèrement inférieures. Le PAx est également plus traumatique et est associé à davantage d’inconfort postopératoire que le PLMA.

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Copyright information

© Canadian Anesthesiologists 2007

Authors and Affiliations

  • Alexandre Lallo
    • 1
  • Pierre Drolet
    • 1
  • Mélanie Lacroix
    • 1
  1. 1.Department of AnesthesiologyUniversity of MontrealMontrealCanada

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