Glottic insertion of the ProSeal LMA occurs in 6% of cases: a review of 627 patients.

Purpose: Glottic insertion of the ProSeal Laryngeal Mask Airway (PLMA) has received little attention in the anesthesiology literature. We investigated the incidence and depth of insertion associated with this important cause for a failed insertion attempt with the PLMA.

Methods: With Institutional Review Board approval, we reviewed 15-months' use of the PLMA.

Paradoxical embolism in the left main coronary artery: diagnosis by transesophageal echocardiography.

We describe a patient with a paradoxical coronary embolism diagnosed by transesophageal echocardiography. The patient developed a stroke followed by a myocardial infarction. Coronary angiography showed an obstruction of the left main coronary artery.

Maximum minute ventilation test for the ProSeal laryngeal mask airway.

Unlabelled: One of the distinguishing features of the ProSeal laryngeal mask airway (PLMA) is that it can cause upper airway obstruction, even when it is correctly inserted behind the cricoid cartilage. We used a hyperventilation test, the maximum minute ventilation test (MMV test), to aid in the diagnosis of upper airway obstruction after PLMA insertion. The patient was briefly hyperventilated for 15 s yielding a MMV value equal to 4 x (breaths/15 s) x (exhaled tidal volume).

Gastric distention in a spontaneously ventilating patient with a ProSeal laryngeal mask airway.

Partial upper airway obstruction during spontaneous respiration with a ProSeal laryngeal mask airway can result in gastric distention.

Esophageal insufflation with normal fiberoptic positioning of the ProSeal laryngeal mask airway.

Esophageal insufflation can occur simultaneously with venting from the drain tube during positive pressure ventilation with the ProSeal laryngeal mask airway.