Comparison of ProSeal laryngeal mask airway size 2 and 2½ in anesthetized and paralyzed pediatric patients with same weight group: A prospective randomized clinical study

CONTEXT: ProSeal laryngeal mask airway (PLMA) efficacy in pediatric anesthesia. AIMS: The aim of this study was to compare PLMA size 2 and 2½ in anesthetized paralyzed pediatric patients weighing 20–30 kg undergoing elective surgery. SETTINGS AND DESIGN: A prospective randomized study was conducted in a tertiary care teaching hospital. MATERIALS AND METHODS: A total of 60 American Society of Anesthesiologists I pediatric patients of either sex having body weight between 20 and 30 kg undergoing elective surgeries were randomly allocated to PLMA of either size 2 or 2½. Standardized anesthetic technique with propofol, sevoflurane, vecuronium bromide, nitrous oxide was used in all patients. Parameters such as number of attempts, time to achieve an effective airway, hemodynamic parameters, drain tube test, oropharyngeal leak pressure (OPL), gastric tube placement, and postoperative adverse events were noted. Statistical analysis by Kolmogorov-Smirnov analysis, Mann-Whitney U-test, Student's t-test, Wilk's lambda test and power analysis was done. RESULTS: There were no significant differences in demographic variables, ease of insertion and ventilation, number of insertion attempts, hemodynamics, and postoperative complications. OPLs were slightly higher in PLMA size 2½ (27.38 ± 6.36 vs. 22.62 ± 2.85 cm H(2)O, respectively; P = 0.001) than size 2. CONCLUSIONS: Both PLMA size 2 and 2½ provided adequate seal pressures that would allow positive pressure ventilation in healthy children. Thus PLMA of either size 2 or 2½ can be used as a reliable airway device in children weighing 20-30 kg.