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Laryngeal tube S II, ProSeal laryngeal mask, and EasyTube during elective surgery: a randomized controlled comparison with the endotracheal tube in nontrained professionals

Cavus, Erol; Deitmer, Wiebke; Francksen, Helga; Serocki, Goetz; Bein, Berthold; Scholz, Jens; Doerges, Volker

European Journal of Anaesthesiology (EJA): September 2009 - Volume 26 - Issue 9 - p 730–735
doi: 10.1097/EJA.0b013e32832a9932
Original Articles – General

Background and objective EasyTube (EZT), ProSeal laryngeal mask airway (PLMA), and Laryngeal tube S II (LTS II) have recently been introduced as supraglottic airway devices and have been proposed as emergency airway alternatives. The purpose of this study was to compare the performance of the three devices, if used by anaesthesiologists without extensive hands-on training, with the endotracheal tube during routine surgical procedures.

Methods After informed consent, 88 ASA I–II patients scheduled for routine minor surgery were randomly allocated to EZT (n = 22), PLMA (n = 22), and LTS II (n = 22) groups and the endotracheal tube (n = 22) group, respectively. Overall success rates, insertion times, cuff pressures, and resulting airway leak pressures as well as subjective assessment of handling were determined.

Results Overall insertion success rate of the EZT, PLMA, LTS II, and endotracheal tube was 14 out of 22 (64%), 20 out of 22 (91%), 21 out of 22 (96%), and 21out of 22 (96%), respectively. Time to first successful ventilation with the EZT was significantly (P < 0.05) longer than that with PLMA, LTS II, and endotracheal tube [median (minimum–maximum): 56 (27–150), 25 (12–70), 24 (11–150), and 20 (8–74) s, respectively]. The lowest airway leak pressure could be observed with the EZT [median (minimum–maximum), 19 (9–40) cmH2O] and the highest airway leak pressure with the LTS II [median (minimum–maximum), 40 (22–40) cmH2O]. Subjective assessment of handling was significantly (P < 0.05) poorer in the EZT group compared with PLMA, LTS II, and endotracheal tube groups, respectively.

Conclusion In contrast to the EZT, both PLMA and LTS II proved to be suitable for routine airway management by anaesthesiologists without extensive hands-on device training.

Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany

Received 19 November, 2008

Revised 26 January, 2009

Accepted 17 February, 2009

Correspondence to Dr Erol Cavus, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, D-24105 Kiel, Germany Tel: +49 431597 3739; fax: +49 431597 3002; e-mail: cavus@anaesthesie.uni-kiel.de

Presented at the American Society of Anesthesiologists Annual Meeting, Orlando, 2008.

© 2009 European Society of Anaesthesiology