The PAXpress airway causes more pharyngeal irritation than the reusable laryngeal mask airway.

This study aimed to determine whether the PAXpress airway (Vital Signs, Totawa, NJ) should replace the standard laryngeal mask airway (LMA Classic) in our practice. Records of patients who had been ventilated with a PAXpress airway or an LMA were examined. Responses of patients in the postanesthesia care unit (PACU) or from routine postoperative calls the following day were noted. Insertion of the airway was easy in all of the LMA patients but in only 20% of the PAXpress patients. Blood was noticed on 27% (4/15) of the PAXpress airways but on none of the LMAs. None of the LMA patients complained of pharyngeal soreness in the PACU, whereas 33% (5/15) in the PAXpress group had a sore throat. The next day, only 2 patients in the LMA group (13%) complained of a slightly sore throat. In the PAXpress group, all but 2 of the 13 patients interviewed (85%) reported a sore throat. The average degree of soreness for this group (4.5) was significantly higher than that reported in the LMA group (P < .001). The PAXpress airway is more likely to cause irritation (often severe) of the airway and, therefore, should not replace the standard LMA in our practice.