scholarly journals Prospective, Randomized Comparison of Proseal Laryngeal Mask Airway and Endotracheal Tube in Adults Selected for Elective Laparoscopic Abdominal Surgery

2021 ◽  
pp. 320-324
Author(s):  
Narendran Karthigayan
Keyword(s):  
Laryngeal Mask Airway ◽  
Abdominal Surgery ◽  
Endotracheal Tube ◽  
Muscle Relaxant ◽  
Proseal Laryngeal Mask Airway ◽  
Laryngeal Mask ◽  
P Value ◽  
Intubation Time ◽  
Significant Difference ◽  
Sealing Pressure

Both PLMA and SLIPA were easy to insert (100% success) and ventilate with maximum sealing pressure of 30cm H2o (P = 0.4) with no muscle relaxant. No significant difference (P = 0.265) in intubation time between PLMA and ETT were observed in the study. A significant SpO2 change (P = 0.804, 0.561, 0.657, 0.248, 0.561) measured Pre op, Pre intubation, lmt, 3 mt and 5mts after intubation and there were no significant EtCO2 changes (P =0.861, 0.251, 0.44) measured after intubation was observed. Blood staining in 1/25 cases with PLMA and 2/25 cases with ETT with a P value of 0.561was seen.

scholarly journals Second-generation laryngeal mask airway as an alternative to endotracheal tube during prolonged laparoscopic abdominal surgery: a comparative analysis of intraoperative gas exchanges

2021 ◽  
Author(s):  
S Park ◽  
JE Lee ◽  
GS Choi ◽  
JM Kim ◽  
JS Ko ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Gas Exchange ◽  
Laryngeal Mask Airway ◽  
Abdominal Surgery ◽  
Partial Pressure ◽  
Endotracheal Tube ◽  
Second Generation ◽  
Laryngeal Mask ◽  
Arterial Partial Pressure ◽  
Prolonged Surgery

Introduction: Despite several advantages over endotracheal tube (ETT), laryngeal mask airway (LMA), which is used in emergencies under difficult airway maintenance conditions, is rarely utilized in prolonged surgery. We compared the variables representing intraoperative gas exchange with second-generation LMA and ETT during prolonged laparoscopic abdominal surgery. Methods: Prolonged surgery was defined as a surgery lasting more than 2 h. In total, 394 patients who underwent laparoscopic liver resection via either second-generation LMA or ETT were retrospectively analysed. Parameters including end-tidal pressure of carbon dioxide (ETCO2), tidal volume (TV), respiratory rate (RR), peak inspiratory pressure (PIP), arterial partial pressure of carbon dioxide (PaCO2), pH, and ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PFR) during surgery were compared between the two groups. In addition, the incidence of postoperative pulmonary complications (PPC) including pulmonary aspiration was also compared. Results: The values of ETCO2, TV, RR and PIP during pneumoperitoneum were comparable between the two groups. Although PaCO2 at 2 h after induction was higher in patients with LMA (40.5 vs. 38.5 mmHg, p < 0.001), the pH and PFR values of the two groups were comparable. The incidence of PPC was not different. Conclusion: During prolonged laparoscopic abdominal surgery, the second-generation LMA facilitates adequate intraoperative gas exchange and represents an alternative to ETT.

Comparison of Proseal Laryngeal Mask Airway Versus Endotracheal Tube in Anaesthetized Adult Patients

2018 ◽  
Vol 5 (3) ◽  
pp. 415-418
Author(s):  
Saranjit Singh ◽  
◽  
Sapna Bansal ◽  
Rahul Midda ◽  
Dhanwant Kaur ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Endotracheal Tube ◽  
Proseal Laryngeal Mask Airway ◽  
Adult Patients ◽  
Laryngeal Mask

The ProSeal Laryngeal Mask Airway

2000 ◽  
Vol 93 (1) ◽  
pp. 104-109 ◽  
Author(s):  
Joseph Brimacombe ◽  
Christian Keller
Keyword(s):  
Laryngeal Mask Airway ◽  
Gastric Tube ◽  
Proseal Laryngeal Mask Airway ◽  
Laryngeal Mask ◽  
Drainage Tube ◽  
Tube Placement ◽  
Success Rates ◽  
Sealing Pressure ◽  
Effective Seal ◽  
First Time

Background The ProSeal laryngeal mask airway (PLMA) is a new laryngeal mask device with a modified cuff to improve seal and a drainage tube to provide a channel for regurgitated fluid and gastric tube placement. In the present randomized, crossover study, the authors tested the hypothesis that ease of insertion, airway sealing pressure, and fiberoptic position differ between the PLMA and the standard laryngeal mask airway (LMA). For the PLMA, we also assess ease of gastric tube placement and the efficacy of an introducer tool. Methods Sixty paralyzed, anesthetized adult patients were studied. Both devices (only size 4) were inserted into each patient in random order. Airway sealing pressure and fiberoptic position were determined during cuff inflation from 0 to 40 ml in 10-ml increments. Gastric tube insertion was attempted with the PLMA if there was no gas leak from the drainage tube. In 60 additional patients, ease of insertion for the PLMA was compared with and without an introducer. Results First-time success rates were higher (60 of 60 vs. 52 of 60; P = 0.003) and the effective airway time shorter (9 +/- 3 s vs20 +/- 18 s; P &lt; 0.0001) for the LMA. There were no failed uses of either device within three attempts. Airway sealing pressure was 8-11 cm H2O higher for the PLMA at all cuff volumes (P &lt; 0.00001) and was higher in females for both devices. Fiberoptic position was better with the LMA at all cuff volumes (P &lt; 0.00001), but vocal cord visibility was similar (LMA, 59 of 60; PLMA, 56 of 60). For the PLMA, gastric tube placement was successful in 58 of 58 patients and took 9 +/- 5 s. First-time success rates were higher (59 of 60 vs53/60; P = 0.03) and the effective airway time shorter (15 +/- 13 s vs 23 +/- 18 s; P = 0.008) with the introducer. Conclusion The PLMA is capable of achieving a more effective seal than the LMA and facilitates gastric tube placement, but it is more difficult to insert unless an introducer tool is used. When correctly positioned, the PLMA isolates the glottis from the upper esophagus with possible implications for airway protection.

scholarly journals LOW FLOW ANESTHESIA

2016 ◽  
Vol 23 (12) ◽  
pp. 1522-1526
Author(s):  
Hamid Raza ◽  
Bashir Ahmed ◽  
Mr Kamlaish
Keyword(s):  
Laryngeal Mask Airway ◽  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Tertiary Care ◽  
Laryngeal Mask ◽  
Low Flow ◽  
Care Hospital ◽  
Asa Classification ◽  
Significant Difference ◽  
Low Flow Anesthesia

Objectives: The aim of our study is to determine the incidence of complicationswhen using Laryngeal mask airway and compare it with endotracheal tube intubation, duringadministration of low flow anesthesia. Study Design: A randomized control trial. Period: 3months from February 2015 to April 2015. Setting: Tertiary Care Hospital in Karachi Pakistan.Materials and Methods: The study population consisted of n= 100 patients who underwentelective operative procedures of the eye. Patients who belonged to the ASA classification typeI and II were allocated into two groups using a random number generator. Group A consistedof all the patients on whom endotracheal tube was used as airway and group B included all thepatients on whom Laryngeal mask airway was used. The complications were noted on a predesignedproforma. Data was analyzed using SPSS version 23. Results: The study populationconsisted of n= 100 patients out of which n= 43 were males and n= 57 were females, 42%of the patients belonged to ASA classification I and 58% belonged to the ASA classificationII. Leakage of air was observed in 7% of the patients, postoperative shivering was observedin 20%, sore throat was observed in n= 22 patients, of which n= 18 patients belonged to theETT group and n= 4 patients belonged to the LMA group. Endotracheal carbon dioxide levelsdid not show any significant difference. Conclusion: According to the results of our study,Laryngeal mask airway has a lower incidence of post-operative complications, provided that itspositioning and cuff pressure are noted and maintained regularly, and it can be used as a safealternative to endotracheal intubation when using low flow controlled anesthesia respectively.

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