*7.3.1.3 Size selection, practical aspect, adjuncts*

Sizes 3 to 5 were introduced in 2000 and sizes 1½-2½ in 2004. Sizes 1½-2½ have no dorsal cuff. Device properties and recommendations for use are given in **Table 3**. The pLMA is reusable and recommended product life is 40 sterilisations. Not all protein material can be removed by routine cleaning of laryngeal masks and this raises theoretical concerns over cross-infection risk, hence steam autoclaving is the recommended method of sterilising this device.

**Figure 4.** *Parts of Proseal LMA.*

First generation SGAs have only a single lumen for ventilation. There is risk of regurgitation of gastric contents and aspiration with positive pressure ventilation. To combat this risk, a separate channel was incorporated into this design to allow for gastric drainage and provide better seal. Several modifications of the Classic

**Mask size Patient weight Maximum cuff volume of air (ml)**

 Neonates/infants up to 5 kg 4 1.5 Infants 5–10 kg 7 Infants/children 10–20 kg 10 2.5 Children 20–30 kg 14 Children 30–50 kg 20 Adults 50–70 kg 30 Adults 70–100 kg 40 Large adults over 100 kg 50

*Special Considerations in Human Airway Management*

A second-generation SGA is one with design features (higher oropharyngeal seal pressures and oesophageal drain tubes) specifically intended to reduce the risk of

The Proseal LMA™ (Teleflex®, USA) designed by Dr. Archie Brain, is based on the cLMA. It was introduced in the year 2001. In comparison to the cLMA, it has a

LMA were done and lead to the invention of second-generation SGAs.

**7.3 Second generation SGA**

*7.3.1 LMA Proseal™ (pLMA)*

aspiration [33].

**Figure 3.** *Classic LMA in-situ.*

**Table 2.**

*Available classic LMAs.*

*7.3.1.1 Introduction*

**258**


#### **Table 3.**

*Available Proseal LMAs.*

The pLMA is accompanied by a cuff deflator (**Figure 5**) and insertion tool (**Figures 6** and **7**). The cuff deflator assists complete deflation and flattening the device tip before insertion to improve insertion success.

**Figure 6.**

**Figure 7.** *Insertion tool.*

**Figure 8.**

**261**

*Parts of LMA supreme.*

*pLMA with insertion tool.*

*Second Generation Supraglottic Airway (SGA) Devices DOI: http://dx.doi.org/10.5772/intechopen.93947*
