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Proseal Laryngeal Mask Airway v/s Endotracheal Intubation for Gynaecological Laparoscopic Surgeries

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Background: Proseal LMA (PLMA), is the latest entrant in the family of LMA designed for positive pressure ventilation and protection against aspiration. These features of PLMA is especially useful in laparoscopy surgeries, which is widely preferred these days and can act as an alternative to Endotracheal tube (ETT). Rigid laryngoscopy during endotracheal intubation (gold standard for safe glottic seal) causes haemodynamic responses which adds to the stress of pneumoperitoneum in laparoscopic surgeries, unlike Proseal LMA which is a supraglottic device and less invasive. Aim: To compare the efficacy and safety of Proseal Laryngeal Mask Airway with Portex endotracheal intubation in gynaecological laparoscopic surgeries under general anesthesia. Setting and Design: A prospective, randomised study was conducted in 60 females, ASA-I & ASA-II patients undergoing laparoscopic gynaecological surgery under general anesthesia. Ethical clearance and written consent was obtained before the study. Patients were randomly divided into two groups-PLMA (P) and Endotracheal tube (E) depending on the device used to secure airway. Ease, attempt of of insertion, haemodynamic parameters and postoperative complications were studied. Results: Insertion rate was 100% in both the groups. Vital parameters like heart rate, systolic bp, diastolic bp and mean arterial pressure were relatively lower with Proseal LMA at 1 min, 3 min and 5 min and after removal as compared to ETT. The difference was statistically significant. There was no significant difference in End tidal CO2, SpO2, during baseline, insertion and removal of device, before and after pneumoperitoneum, also in airway pressure during insertion, before and after pneumoperitoneum. Perioperative complication was higher with endotracheal tube. Conclusion: The Proseal LMA offers a safe and effective alternative for airway management in patients undergoing gynaecological laparoscopic procedures under general anesthesia.

Perspectives

Background: Proseal LMA (PLMA), is the latest entrant in the family of LMA designed for positive pressure ventilation and protection against aspiration. These features of PLMA is especially useful in laparoscopy surgeries, which is widely preferred these days and can act as an alternative to Endotracheal tube (ETT). Rigid laryngoscopy during endotracheal intubation (gold standard for safe glottic seal) causes haemodynamic responses which adds to the stress of pneumoperitoneum in laparoscopic surgeries, unlike Proseal LMA which is a supraglottic device and less invasive. Aim: To compare the efficacy and safety of Proseal Laryngeal Mask Airway with Portex endotracheal intubation in gynaecological laparoscopic surgeries under general anesthesia. Setting and Design: A prospective, randomised study was conducted in 60 females, ASA-I & ASA-II patients undergoing laparoscopic gynaecological surgery under general anesthesia. Ethical clearance and written consent was obtained before the study. Patients were randomly divided into two groups-PLMA (P) and Endotracheal tube (E) depending on the device used to secure airway. Ease, attempt of of insertion, haemodynamic parameters and postoperative complications were studied. Results: Insertion rate was 100% in both the groups. Vital parameters like heart rate, systolic bp, diastolic bp and mean arterial pressure were relatively lower with Proseal LMA at 1 min, 3 min and 5 min and after removal as compared to ETT. The difference was statistically significant. There was no significant difference in End tidal CO2, SpO2, during baseline, insertion and removal of device, before and after pneumoperitoneum, also in airway pressure during insertion, before and after pneumoperitoneum. Perioperative complication was higher with endotracheal tube. Conclusion: The Proseal LMA offers a safe and effective alternative for airway management in patients undergoing gynaecological laparoscopic procedures under general anesthesia.

Red Flower Publication Publications
Red Flower Publication Pvt Ltd

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This page is a summary of: Proseal Laryngeal Mask Airway v/s Endotracheal Intubation for Gynaecological Laparoscopic Surgeries, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6419.31.
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