Comparison of the classic, flexible and proseal laryngeal mask airway in patients with simulated difficult airway

We aimed to compare the clinical performance of the classical LMA, proseal LMA and flexible LMA in patients with simulated difficult airway using a semirigid cervical collar. Following the Ethics Committee approval and informed patient consents, aged 18-80 years, ASA I-III ninety patients were included in the study. Patients were randomly allocated to three groups. In Group I PLMA, in Group II FLMA and Group III cLMA were used according to patients age, weight and manifacturer's instructions. Difficult laryngoscopy was simulated using a semirigid cervical collar. Maximum mouth opening, thyromental distance, sternomental distance and neck circumference from the thyroid cartilage were measured before LMA insertion. There was no diffence between groups regarding the demographic data. Insertion time and attempts, ease of insertion, oropharyngeal leak pressure, fiberoptic view grade and rate of complications were similar (p>0,05). Insertion success was high in each group. In conclusion, all types of laryngeal masks had similar clinical performance during difficult airway conditions. We concluded that first and second generation supraglottic airway devices have no superiority over one another for patients with limited cervical motion due to neck immobilization.