The ProSeal laryngeal mask airway and the laryngeal tube Suction for ventilation in gynaecological patients undergoing laparoscopic surgery.
OBJECTIVE
ProSeal Laryngeal Mask Airway (PLMA) and Laryngeal Tube Suction (LTS), supraglottic airway devices allowing gastric drainage, were compared in this prospective, randomized study for airway management under conditions with elevated intra-abdominal pressure induced by capnoperitoneum.


METHODS
Fifty patients undergoing elective gynaecological laparoscopic surgery were randomized to two groups of 25 each. After induction of general anaesthesia, devices were inserted, correct placement was verified, airway leak pressure was measured, and a gastric tube was inserted. Ease of insertion, quality of airway seal, risk of gastric insufflation and patient comfort were investigated.


RESULTS
There were no differences in patient characteristics data for both groups. First-time insertion success rates were comparable for both groups: 92%--first attempt, 8%--second attempt for PLMA and LTS. Time until delivery of the first tidal volume for PLMA and LTS was 23.2 +/- 6.1 and 23.5 +/- 6.6s, airway leak pressure was 45.4 +/- 4.9 cmH2O and 45.6 +/- 6.7 cmH2O with cuff pressures adjusted to 60 cmH2O. No gastric insufflation, gas loss or signs of regurgitation were detected. Placement of a gastric tube was successful in all patients. Patients were questioned for sore throat and dysphagia after removal of devices. Sore throat was stated in 1%/0% (PLMA) and 8%/4% (LTS) after 6/24 h, dysphagia in 4%/4% (PLMA) and 12%/4% (LTS).


CONCLUSIONS
Both devices provide a secure airway even under conditions of elevated intra-abdominal pressure. In this pilot study, no differences concerning handling or quality of airway seal were detected between PLMA and LTS.
Roth
H
H
University Hospital Mannheim, Institute of Anaesthesiology and Intensive Care Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Manheim, Germany. haroth@t-online.de
Genzwuerker
H V
HV
Rothhaas
A
A
Finteis
T
T
Schmeck
J
J
D000328:Adult; D000768:Anesthesia, General; D005260:Female; D005773:Gastroscopy; D006801:Humans; D007327:Insufflation; D007431:Intraoperative Complications / Q000453:epidemiology; D007441:Intubation, Gastrointestinal; D007442:Intubation, Intratracheal; D010535:Laparoscopy; D017214:Laryngeal Masks; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010612:Pharyngitis / Q000453:epidemiology; D011028:Pneumoperitoneum, Artificial; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*; D013396:Suction