LMA Unique TM & the Self Pressurized Air-Q TM Intubating Laryngeal Airway in Children

The purpose of this study is to compare the clinical efficacy of the air-Q ILA-SP with the current standard of care, the LMA Unique in anesthetized non-paralyzed pediatric patients.

The goal for this randomized, non-crossover investigation is to compare a disposable version of the standard LMA, LMA Unique TM,with the air-Q ILA-SP in pediatric patients. Oropharyngeal leak pressure is commonly used as an indicator of airway seal adequacy. Similarly, flexible fiberoptic bronchoscope examination is often employed to assess proper placement of airway devices. We hypothesize that airway leak pressures with the ILA-SP will be superior to the LMA upon initial device placement, and ten minutes after device placement. Airway leak pressures will be measured by recording the circuit pressure at which equilibrium is reached. Ease of placement, fiberoptic grade of laryngeal view, and complications (airway related, gastric insufflation, trauma) will also be assessed.

Children weighing 20 to 30 kg undergoing surgery requiring a supraglottic airway device

• Device: Laryngeal Mask Airway
  Each child will be randomized to either receiving the LMA or air-Q ILA-SP as their supraglottic airway device for primary airway maintenance.
  Other Name: Laryngeal Mask AirwayTM (Laryngeal Mask Airway North America; San Diego, CA USA)
• Device: air-QTM Intubating Laryngeal Airway
  Each child will be randomized to either receiving the LMA or air-Q ILA-SP as their supraglottic airway device for primary airway maintenance.
  Other Name: air-QTM Intubating Laryngeal Airway Mercury Medical;Clearwater, Fl USA

• Laryngeal Mask airway (LMA)
  children weighing 20 to 30 kg
  Intervention: Device: Laryngeal Mask Airway
• Intubating Laryngeal Airway (ILA-SP)
  Children weighing 20-30 kg
  Intervention: Device: air-QTM Intubating Laryngeal Airway

• Jagannathan N, Sohn LE, Mankoo R, Langen KE, Roth AG, Hall SC. Prospective evaluation of the self-pressurized air-Q intubating laryngeal airway in children. Paediatr Anaesth. 2011 Jun;21(6):673-80.
• Shimbori H, Ono K, Miwa T, Morimura N, Noguchi M, Hiroki K. Comparison of the LMA-ProSeal and LMA-Classic in children. Br J Anaesth. 2004 Oct;93(4):528-31. Epub 2004 Aug 6.
• White MC, Cook TM, Stoddart PA. A critique of elective pediatric supraglottic airway devices. Paediatr Anaesth. 2009 Jul;19 Suppl 1:55-65. Review.

Inclusion Criteria:

• Children undergoing general anesthesia using a supraglottic airway device
• 3 to 9 years of age
• 20 to 30 kilograms in weight

Exclusion Criteria:

• History of a difficult airway
• Active gastrointestinal reflux
• Active upper respiratory tract infection