Comparison of ultrasonography and flexible bronchoscopy for evaluation of placement of ProSeal Laryngeal Mask Airway in paediatric patients undergoing elective surgery under general anaesthesia

This study is intended to evaluate the feasibility of using ultrasound to evaluate the placement of a ProSeal LMA (PLMA) compared to the gold standard bronchoscopy. Children aged 3 to 12 years planned for elective surgery in supine position under general anaesthesia with ProSeal LMA placement will be selected for this study. Inj Fentanyl (2 mcg/kg) + Inj Propofol (2 mg/kg) will be given for induction. Inj Vecuronium (0.1 mcg/kg) will be given for facilitating PLMA placement. PLMA of appropriate size (according to weight based criteria) will be inserted. Placement of PLMA will be confirmed using clinical parameters (Visible bilateral chest rise , bilateral equal air entry on auscultation, SPO2 > 95%, successful insertion of gastric tube, capnogram). Patients with ‘Clinically acceptable’ placed PLMA will be selected for this study. In these patients USG will be done followed by flexible bronchoscopy. Ultrasonographic evaluation of placement of PLMA will be done in 3 planes and scoring will be done. Flexible bronchoscopic evaluation of placement of PLMA and Brimacombe grading will be done.  After completion of surgery, neuromuscular blockade reversal will be given and trachea will be extubated. Patient will be observed in PACU for 2 hours. This study aims to correlate the number of USG-acceptable PLMA placements with number of flexible bronchoscope confirmed correct PLMA placements.