A Comparison of Different Ventilation Strategies in Children Using the Proseal™ Laryngeal Mask Airway

The laryngeal mask airway (LMA) is a breathing device that sits above the vocal cords and allows the patient to breathe in and out adequately under general anesthesia (GA). The ProSeal™ LMA (PLMA™) is a specialized type of LMA with a design that permits the delivery of higher pressures to help the patient breathe in and out (ventilate) and also contains a channel to suction the stomach.

Children under GA may breathe through a PLMA in different ways. Spontaneous ventilation consists of the children breathing on their own through a PLMA™. Pressure support ventilation allows the patient to breathe on their own with additional help from the anesthesia machine. Pressure control ventilation allows the patient to breathe with the help of an anesthesia machine.

A child undergoing surgery requires a deep level of general anesthesia which negatively affects their ability to ventilate. Thus, children may not breathe in oxygen and carbon dioxide out adequately at this level of anesthesia and it may be beneficial to provide some level of support to enhance carbon dioxide exchange and to avoid hypoventilation.

This study will attempt to determine whether pressure support ventilation improves ventilation in children undergoing outpatient surgery.

Inclusion criteria

• ASA physical classification 1,2 (Healthy or relatively healthy children)
• Subjects scheduled for outpatient surgical procedures.
• Surgical procedure anticipated to be < 90 minutes
• Subject weight of ≤ 20 kg (44 lbs)
• Subject age of 12 months to 5 years (inclusive)

Exclusion criteria

• Inpatient
• ASA physical classification of 3, 4 or E (sick children)
• Risk of aspiration
• Subjects with malignant hyperthermia or family history of malignant hyperthermia
• Subjects with tracheostomies