The LMA® ProtectorTM in anaesthetised, non-paralysed patients: a multicentre prospective observational study

We evaluated the LMA((R)) Protector(TM) in 280 ASA physical status 1-3 patients aged 18-75 years by assessing the ease of insertion, insertion time, oropharyngeal leak pressure, ease of gastric tube passage and complications. First-attempt and overall insertion success was 234/280 (84; 95%CI 79-88%) and 274/280 (98; 95-99%). Median (IQR [range]) insertion time was 17 (12-25 [5-44]) s, and manoeuvres to facilitate insertion were required in 56 (50-63)% of patients. Median oropharyngeal leak pressure was 31 (26-36 [14-40]) cmH(2)O. Multivariate analysis identified two risk factors for oropharyngeal leak pressure < 25 cmH(2)O: male sex (OR 2.44; 1.01-5.91, p = 0.048) and the insertion of a LMA size different to that recommended by weight (OR 1.98; 0.97-4.03, p = 0.06). Gastric tube insertion was possible in 256 out of 274 patients (93%). On fibreoptic view, vocal cords were visible in 86% of patients. During maintenance, 14 patients (5%) required airway manipulation. There were no episodes of regurgitation or aspiration. Blood staining on LMA removal was present in 70 out of 280 patients (25%). Use of the LMA Protector appears safe and is associated with a high success rate, provision of a highly effective seal and low rates of clinical complications. These attributes would suggest considerable potential for use during anaesthesia.