Anaesthesia · Airway Management (Difficult Airway, Intubation, Airway Devices)

A Proseal LMA (PLMA) compared to a Classic LMA (CLMA) has an additional advantage in the anaesthetic management of laparoscopic surgery because it:

  • A Allows positive pressure ventilation up to 40 cmH2O without risk of gas leak
  • B Can be inserted without requiring jaw opening or neck movement
  • C Provides a higher seal pressure (40 cmH2O) without the drainage lumen
  • D Has a second drainage lumen that allows passage of a gastric tube to drain gastric contents
Correct answer: D. Has a second drainage lumen that allows passage of a gastric tube to drain gastric contents

Explanation

The ProSeal LMA has two key advantages over the Classic LMA: a higher oropharyngeal seal pressure (approximately 30 cmH2O versus 20 cmH2O for CLMA), and a dedicated second drainage/gastric channel that runs alongside the airway tube, allowing a gastric tube to be passed to decompress the stomach and drain regurgitated contents. This drainage channel is particularly important in laparoscopy (where gastric distension from intraperitoneal gas and Trendelenburg positioning increase regurgitation risk) and in allowing confirmation of correct placement (by absence of leak through the gastric channel during ventilation).

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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