Protection against aspiration with the Proseal laryngeal mask airway

The incidence of pulmonary aspiration associated with the use of a standard laryngeal mask airway (LMA) is approximately two per 10,000 cases1, and it is commonly used only when the regurgitation risk is judged to be low. The ProSeal(R) LMA (Intavent Limited, Reading, United Kingdom) incorporates a dorsal cuff, to improve the glottic seal, and an oesophageal drain tube. The drain tube may prevent gastric insufflation with positive pressure ventilation, allow regurgitated fluid to bypass the glottis, and permit the passage of a gastric tube if required2. Both the dorsal cuff and the drain tube have been shown to be important in the prevention of glottic soiling in a cadaveric model3, and we are aware of only a single clinical case report demonstrating its efficacy in the clinical setting4.

We report the case of...