INTRACUFF PRESSURES DO NOT PREDICT LARYNGOPHARYNGEAL DISCOMFORT AFTERUSE OF THE LARYNGEAL MASK AIRWAY

Background: The laryngeal mask airway (LMA) is a large foreign body th at exerts pressure on the pharyngeal mucosa, which may lead to throat discomfort. To determine whether intracuff pressures are associated wi th such discomfort, a randomized, double-blind study was performed to determine the effect of high versus low intracuff pressures. Methods: Seventy healthy women were randomly allocated to two groups with diffe rent LMA intracuff pressures: 30 mmHg (low pressure) or 180 mmHg (high pressure). Pressures were controlled with, a microprocessor-controlle d monitor. Insertion of the LMA was performed by one investigator and facilitated with propofol and verified fiberoptically. Anesthesia was maintained with enflurane and nitrous oxide. The LMAs were removed whi le the patients were still asleep. Patients assessed their laryngophar yngeal complaints (sore throat, dysphagia, hoarseness) at 8, 24, and 4 8 h after operation on a 101-point numerical rating scale. Results: No significant difference was found in the overall incidence of complain ts between both groups (low pressure: 50%; high pressure: 42%). On the day of surgery, dysphagia (38%) was more frequent than sore throat (1 6%) or hoarseness (6%) (P < 0.05) within the high-pressure group. In t he low pressure group, the incidence of these complaints was not signi ficantly different (33%, 20%, and 23%, respectively). On the following day, dysphagia was still present in 20% of the women in both groups, and other symptoms comprised 10% or less of the reported complaints. C onclusions: Differences in LMA intracuff pressures did not influence e ither the incidence or severity of laryngopharyngeal complaints.