Skip to main content
SpringerLink
Log in

The uses of laryngeal mask airway ProSeal™ and endobronchial blocker for one lung anesthesia

  • Original Article
  • Published:
Journal of Anesthesia Aims and scope Submit manuscript

Abstract

Purpose

The use of an endobronchial blocker in conjunction with a supraglottic device in elective thoracic cases has never been studied. The aim of this study was to report the success rate and time to placement of the endobronchial blocker in anaesthetized patients with a laryngeal mask airway (LMA)-ProSeal™ in place.

Methods

This was a single-center, prospective, descriptive pilot study that enrolled 30 patients aged 18–75 years, with ASA I–III, who underwent elective thoracotomy or video-assisted thoracoscopy. We collected data on time to placement of the endobronchial blocker into the selected bronchus, time consumed for final blocker positioning and inflation, lung deflation score at chest opening, and postoperative airway complications.

Results

One patient was excluded because of high peak airway pressure during LMA ventilation. The time required for blocker placement in the right main bronchus was shorter [mean 160 (78–480) s] compared with that for the left main bronchus [225 (117–420) s]. The blocker was successfully placed on the first attempt in 25 patients. Lung deflation score graded by the surgeon was 8/10 (median). Minor postoperative airway complications, such as sore throat (28.6 %) and hoarseness of voice (17.9 %), were reported.

Conclusions

The use of LMA-ProSeal™ in conjunction with the COOPDECH Endobronchial Blocker Tube may be considered an alternative one-lung ventilation technique in selected cases. However, success rates and time required for placement of the blocker seem dependent on the operator’s skill. Although postoperative sore throat and hoarseness of voice were reported, these improved in 24 h.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Lohser J. Evidence-based management of one-lung ventilation. Anesthesiol Clin. 2008;26:241–72.

    Article  PubMed  Google Scholar 

  2. Hagihira S, Takashina M, Mori T, Yoshiya I. One-lung ventilation in patients with difficult airways. J Cardiothorac Vasc Anesth. 1998;12:186–8.

    Article  CAS  PubMed  Google Scholar 

  3. Kosarek L, Busch E, Abbas A, Falterman J, Nossaman BD. Effective use of bronchial blockers in lung isolation surgery: an analysis of 130 cases. Ochsner J. 2013;13:389–93.

    PubMed Central  PubMed  Google Scholar 

  4. Campos JH. Lung isolation techniques for patients with difficult airway. Curr Opin Anaesthesiol. 2010;23:12–7.

    Article  PubMed  Google Scholar 

  5. Fabila TS, Menghraj SJ. One lung ventilation strategies for infants and children undergoing video-assisted thoracoscopic surgery. Indian J Anaesth. 2013;57:339–44.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Joshi GP, Inagaki Y, White PF, Taylor-Kennedy L, Wat LI, Gevirtz C, McCraney JM, McCulloch DA. Use of the laryngeal mask airway as an alternative to the tracheal tube during ambulatory Anesthesia. Anesth Analg. 1997;85:573–7.

    CAS  PubMed  Google Scholar 

  7. Maltby JR, Beriault MT, Watson NC, Liepert DJ, Fick GH. LMA-Classic and LMA-ProSeal are effective alternatives to endotracheal intubation for gynecologic laparoscopy. Can J Anaesth. 2003;50:71–7.

    Article  PubMed  Google Scholar 

  8. Devitt JH, Wenstone R, Noel AG, O’Donnell MP. The laryngeal mask airway and positive-pressure ventilation. Anesthesiology. 1994;80:550–5.

    Article  CAS  PubMed  Google Scholar 

  9. Keller C, Brimacombe J. Mucosal pressure and oropharyngeal leak pressure with the ProSeal versus the classic laryngeal mask airway. Br J Anaesth. 2000;85:262–6.

    Article  CAS  PubMed  Google Scholar 

  10. Brimacombe J, Keller C. The ProSeal laryngeal mask airway: a randomized, crossover study with the standard laryngeal mask airway in paralyzed, anesthetized patients. Anesthesiology. 2000;93:104–9.

    Article  CAS  PubMed  Google Scholar 

  11. Maltby JR, Beriault MT, Watson NC, Liepert D, Fick GH. The LMA-ProSeal is an effective alternative to tracheal intubation for laparoscopic cholecystectomy. Can J Anaesth. 2002;49:857–62.

    Article  PubMed  Google Scholar 

  12. Maltby JR, Beriault MT, Watson NC, Liepert DJ, Fick GH. LMA-Classic and LMA-ProSeal are effective alternatives to endotracheal intubation for gynecologic laparoscopy. Can J Anaesth. 2003;50:71–7.

    Article  PubMed  Google Scholar 

  13. Cook TM, Lee G, Nolan JP. The ProSeal laryngeal mask airway: a review of the literature. Can J Anesth. 2005;52:739–60.

    Article  PubMed  Google Scholar 

  14. Ozaki M, Murashima K, Fukutome T. One-lung ventilation using the ProSeal™ laryngeal mask airway. Anaesthesia. 2004;9:726.

    Article  Google Scholar 

  15. Li P, Liang W, Gu H. One-lung ventilation using ProSeal™ laryngeal mask airway and Arndt endobronchial blocker in paediatric scoliosis surgery. Br J Anaesth. 2009;6:902–3.

    Article  Google Scholar 

  16. Robinson AR 3rd, Gravenstein N, Alomar-Melero E, Peng YG. Lung isolation using a laryngeal mask airway and a bronchial blocker in a patient with a recent tracheostomy. J Cardiothorac Vasc Anesth. 2008;22:883–6.

    Article  PubMed  Google Scholar 

  17. Tsuchihashi T, Ide S, Nakagawa H, Hishinuma N, Takano T, Nishizawa M. Differential lung ventilation using laryngeal mask airway and a bronchial blocker tube for a patient with unanticipated difficult intubation. Masui. 2007;9:1075–7 (Article in Japanese).

  18. Howath A, Brimacombe J, Keller C. Gum-elastic bougie-guided insertion of the ProSeal laryngeal mask airway: a new technique. Anaesth Intensive Care. 2002;30:624–7.

    CAS  PubMed  Google Scholar 

  19. Keller C, Brimacombe JR, Keller K, Morris R. Comparison of four methods for assessing airway sealing pressure with the laryngeal mask airway in adult patients. Br J Anaesth. 1999;82:286–7.

    Article  CAS  PubMed  Google Scholar 

  20. Liu EH, Goy RW, Chen FG. An evaluation of poor LMA CTrach view with fibreoptic laryngoscope and the effectiveness of corrective measures. Br J Anaesth. 2006;97:878–2.

    Article  CAS  PubMed  Google Scholar 

  21. Yoshimura T, Ueda K, Kakinuma A, Sawai J, Nakata Y. Bronchial blocker lung collapse technique: nitrous oxide for facilitating lung collapse during one-lung ventilation with a bronchial blocker. Anesth Analgesia. 2014;118:666–70.

    Article  CAS  Google Scholar 

  22. Sharma B, Sehgal R, Sahai C, Sood J. PLMA vs. I-gel: a comparative evaluation of respiratory mechanics in laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2010;26:451–7.

  23. Komasawa N, Ueki R, Itani M, Nomura H, Nishi SI, Kaminoh Y. Evaluation of tracheal intubation in several positions by the Pentax-AWS airway Scope: a manikin study. J Anesth. 2010;24:908–12.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank all the residents and fellows of the 2010 anesthesiology class for their time and effort spent during the manikin testing of different supraglottic devices and bronchial blockers. We also thank Assoc. Prof. Tanyong Pipanmekaporn for assistance with statistical analysis.

Conflict of interest

None of the authors have conflicts of interest to declare.

Author information

Authors and Affiliations

  1. Mahidol University, Bangkoknoi, Bangkok, Thailand

    Prasert Sawasdiwipachai, Settapong Boonsri, Sirilak Suksompong & Paron Prowpan

Authors
  1. Prasert Sawasdiwipachai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Settapong Boonsri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sirilak Suksompong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paron Prowpan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Prasert Sawasdiwipachai.

Additional information

ClinicalTrial.gov ID: NCT02106273

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (doc 33 kb)

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sawasdiwipachai, P., Boonsri, S., Suksompong, S. et al. The uses of laryngeal mask airway ProSeal™ and endobronchial blocker for one lung anesthesia. J Anesth 29, 660–665 (2015). https://doi.org/10.1007/s00540-015-2004-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00540-015-2004-1

Keywords

Search

Navigation