Comparison of effects of ProSeal LMA™ laryngeal mask airway cuff inflation with air, oxygen, air:Oxygen mixture and oxygen:Nitrous oxide mixture in adults: A randomised, double-blind study

Background and Aims: Laryngeal mask airway (LMA) cuff pressure increases when the air is used for the cuff inflation during oxygen: nitrous oxide (O₂:N₂ O) anaesthesia, which may lead to various problems. We compared the effects of different gases for ProSeal LMA™ (PLMA) cuff inflation in adult patients for various parameters. Methods: A total of 120 patients were randomly allocated to four groups, according to composition of gases used to inflate the PLMA cuff to achieve 40 cmH₂ O cuff pressure, air (Group A), 50% O₂:air (Group OA), 50% O₂:N₂ O (Group ON) and 100% O₂ (Group O). Cuff pressure, cuff volume and ventilator parameters were monitored intraoperatively. Pharyngolaryngeal parameters were assessed at 1, 2 and 24 h postoperatively. Statistical analysis was performed using ANOVA, Fisher’s exact test and step‑wise logistic regression. Results: Cuff pressure significantly increased at 10, 15 and 30 min in Group A, OA and O from initial pressure. Cuff pressure decreased at 5 min in Group ON (36.6 ± 3.5 cmH₂ O) (P = 0.42). PLMA cuff volume increased in Group A, OA, O, but decreased in Group ON (6.16 ± 2.8 ml [P < 0.001], 4.7 ± 3.8 ml [P < 0.001], 1.4 ± 3.19 ml [P = 0.023] and − 1.7 ± 4.9 ml [P = 0.064], respectively), from basal levels. Ventilatory parameters were comparable in all four groups. There was no significant association between sore throat and cuff pressure, with odds ratio 1.002. Conclusion: Cuff inflation with 50% O₂:N₂ O mixture provided more stable cuff pressure in comparison to air, O₂:air, 100% O₂ during O₂:N₂ O anaesthesia. Ventilatory parameters did not change with variation in PLMA cuff pressure. Post‑operative sore throat had no correlation with cuff pressure.