[ProSeal-laryngeal mask versus endotracheal intubation in patients undergoing gynaecologic laparoscopy].
BACKGROUND
The aim of this study was to assess the practicality of the ProSeal laryngeal mask (PS-LMA) airway during laparoscopic surgery with capnoperitoneum compared to endotracheal intubation (ET).


METHODS
Prospective, randomized study. 104 patients undergoing gynaecologic, laparoscopic surgery were allocated randomly to two groups: 1. ET-group (n = 50). 2. PS-LMA-group (n = 54). Total intravenous anaesthesia was performed by the same anaesthesiologist.


METHODS
Mean arterial pressure, heart rate, at 4 and circuit pressure at 2 measurement points, and the incidences of coughing and sore throat. Insertion of the ET and the PS-LMA was scored by using a four-point scale. Ease of placing the gastric tube was judged by measuring the number of attempts at insertion and the insertion times. A p-value of < 0.05 was considered as significant.


RESULTS
There were no differences between PS-LMA and ET concerning circuit pressure at any measurement point. At the end of anaesthesia, mean arterial pressure (92 +/- 13 vs. 100 +/- 14 mmHg; p < 0.01) and heart rate (66 +/- 13 vs. 76 +/- 14 beats/min; p < 0.01) were lower in the PS-LMA-group compared to the ET-group. At the end of anaesthesia 25 patients of the ET-group coughed but nobody in the PS-LMA-group (p < 0.00001). There was no difference with regard to postoperative sore throat. The insertion of the PS-LMA was easier compared to ET (p < 0.05), but we found no significant difference concerning insertion times. Fewer attempts at insertion of the gastric tube were necessary in the PS-LMA-group than in the ET-group (p < 0.01), whereas insertion times did not differ.


CONCLUSIONS
The PS-LMA is a convenient and practicable approach for anaesthesia in patients undergoing laparoscopic surgery.
Piper
S N
SN
Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum Ludwigshafen, Ludwigshafen am Rhein. swen.n.piper@t-online.de
Triem
J G
JG
Röhm
K D
KD
Maleck
W H
WH
Schöllhorn
T A H
TA
Boldt
J
J
D000328:Adult; D000368:Aged; D000771:Anesthesia, Intravenous; D001794:Blood Pressure / Q000187:drug effects; D003371:Cough / Q000453:epidemiology / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D013509:Gynecologic Surgical Procedures; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D010535:Laparoscopy; D017214:Laryngeal Masks / Q000009:adverse effects; D008875:Middle Aged; D010612:Pharyngitis / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies