Best practice to cuff pressure monitoring of LMA using a manometer and a reference guide

Purpose of Project: Laryngeal Mask Airways (LMAs) are advanced airways whose use is increasing in general anesthesia procedures. Initial exposure to the device has been through academia and training through various airway workshops, texts, and clinical observation/practice. Directed towards anesthesia providers, this project was focused on bridging the gap between current recommendations to LMA cuff pressure maintenance with current clinical practice in order to avoid hyperinflation by aligning with current manufacturer guidelines of ≤ 60 cm H₂O utilizing a manometer and/or reference guide. Methodology: Various Anesthesiologists and Certified Registered Nurse Anesthetists participated in inserting LMAs (n = 46) and measurement of their cuff pressures. Prior to initiation of the PowerPoint presentation and disbursement of the reference guideline, baseline practice was established for 5 weeks and again for another 3-week post-intervention. A manometer, present in some of the OR, was utilized during the entirety of the study. Results: Using SPSS v28 statistical software, nonparametric, and Man Whitney- U test was performed comparing the pre and post interventional groups, to see if there was a difference in mean pressures. In both groups the mean pressure exceeded the manufacturers' recommendation of 60 cm H₂O, however there was no reduction in mean pressures. Implications for Practice: In performing this study, it is evident that the current clinical practice being conducted was not in alignment with the manufacturer’s recommendations. There is a need to further conduct additional research in order to improve insertion techniques and cuff pressures, so as to increase patient safety and comfort throughout the peri-operative period.D.N.P.Includes bibliographical reference