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• W2090036601 abstract "To the Editor: We read with interest the paper by Brimacombe et al. regarding the Soft Seal™ laryngeal mask airway (SSLM) (1). There have been a number of published papers showing the SSLM to provide similar clinical performance to the Classic™ LMA with significantly less frequent postoperative sore throat and lower incidence of blood on the device (2,3). The intracuff pressure in the SSLM is minimally affected by the diffusion of N2O when compared with the Classic™ LMA (4). We have also shown that the fiberoptic position for both devices to be similar (2). By inflating the cuff of the SSLM to atmospheric pressure before insertion and using size 3 for women and size 4 for men, we have achieved a 100% insertion success rate with only 3% of patients requiring second attempts; 4% had blood-stained LM with an incidence of postoperative sore throat of only 6% (5). It is not clear from the study whether the authors inserted the SSLM with a partially inflated cuff as recommended by its manufacturer, which has been shown to achieve excellent results (2,5). Achieving a seal pressure of 20 cm H2O is thought to correlate best with the correct position of the laryngeal mask rather than the fiberoptic view of the larynx (6). According to the authors’ data regarding the oropharyngeal leak pressure, that was easily achieved in all patients using the SSLM except when it was completely deflated, which is clinically unpracticed. The authors stated that each of the two users in the study has an experience of 50 to 300 uses with each device. It is not clear which device is associated with 50 uses and which device is associated with 300 uses. This makes their statement in the Conclusion “that the level of experience with each device was similar” unclear and vague. We also do not agree with the authors’ conclusion that the SSLM would be less useful as an airway intubator, as the authors in this study did not test the ease of insertion of instruments into the respiratory tract. The SSLM has been shown to be a very effective device when used as an airway intubator (7). There is evidence that the performance of extraglottic airway devices in cadavers is similar to performance in anesthetized patients (8). Interestingly, the same authors compared the ease of insertion and fiberoptic position in cadavers using the Soft Seal™ and Unique™ laryngeal mask airway and achieved 100% success rate in the first attempt in both devices and with no significant difference in the fiberoptic position (9)! B. Al-Shaikh, FCARSI, FRCA William Harvey Hospital Ashford, Kent, UK [email protected] A. A.J. Van Zundert, MD, PhD, FRCA (Hon) Department of Anesthesiology Catharina Hospital Eindhoven, The Netherlands" @default.
• W2090036601 created "2016-06-24" @default.
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• W2090036601 date "2005-07-01" @default.
• W2090036601 modified "2023-09-26" @default.
• W2090036601 title "The Soft Seal Laryngeal Mask Provides Good Ease of Insertion and Clinical Performance" @default.
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• W2090036601 doi "https://doi.org/10.1213/01.ane.0000156720.89642.84" @default.
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