We have assessed a prototype laryngeal mask airway (pLMA) in 50 anaesthetiz
ed children for ease of insertion, oropharyngeal leak pressures, gastric in
sufflation and fibreoptic position. The pLMA has a second smaller mask, whi
ch rests against the upper oesophageal sphincter, and a second cuff to incr
ease the seal pressure of the glottic mask All insertions were graded as ea
sy and an effective airway was achieved in all patients. Oropharyngeal leak
pressure was >40 cm H2O in 49 of 50 patients. Gastric insufflation was not
detected by epigastric auscultation. In 46 of 50 patients, the vocal cords
were seen via a fibreoptic laryngoscope. One patient regurgitated clear fl
uid, but aspiration did not occur. On removal, blood staining was detected
in three of 50 children. We conclude that the pLMA was easy to insert, faci
litated high airway pressure ventilation and may provide some protection ag
ainst gastric insufflation.