title: Gastroesophageal regurgitation during anesthesia and controlled ventilation with six airway devices.
abstract: OBJECTIVE
  To investigate the frequency of gastroesophageal regurgitation and respiratory mechanics during positive pressure ventilation using 5 supraglottic devices or an endotracheal tube (ETT).
  
  
  METHODS
  Prospective, randomized study.
  
  
  METHODS
  Operating rooms in a university-affiliated hospital.
  
  
  METHODS
  180 ASA physical status I and II patients, aged 18 to 65 years old, who underwent elective orthopedic, minor vascular, peripheral plastic, or urologic surgery during general anesthesia.
  
  
  METHODS
  Patients were randomly allocated to one of 6 airway device groups (n = 30 each): (1) Cobra Perilaryngeal Airway; (2) Laryngeal Mask Airway (LMA) Classic; (3) LMA Fastrach; (4) LMA ProSeal; (5) laryngeal tube; and (6) ETT (SIMS Portex, Ltd, Hythe, Kent, UK). After insertion of the designated device, the lungs of each nonparalyzed patient were mechanically ventilated.
  
  
  METHODS
  Hypopharyngeal pH, peak inspiratory pressures, sealing pressures, and lung compliance were measured. Hypopharyngeal pH lower than 4 was considered a regurgitation event.
  
  
  RESULTS
  Regurgitation (episodes of pH <4) occurred in between one and 5 patients of each study group, with no statistical difference. Sealing pressures were similar among all the airway device groups.
  
  
  CONCLUSIONS
  The frequency of gastroesophageal regurgitation in anesthetized, unparalyzed, mechanically ventilated patients was similar in patients whose lungs were ventilated with either the Cobra Perilaryngeal Airway, LMA Classic, Fastrach, ProSeal, laryngeal tube, or ETT.
authors.affiliation: Department of Anesthesia, The E. Wolfson Medical Center, Holon, Israel.
authors.forename: Vadim
authors.initials: V
authors.lastname: Khazin
authors.forename: Tiberiu
authors.initials: T
authors.lastname: Ezri
authors.forename: Ron
authors.initials: R
authors.lastname: Yishai
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Sessler
authors.forename: Francis
authors.initials: F
authors.lastname: Serour
authors.forename: Peter
authors.initials: P
authors.lastname: Szmuk
authors.forename: Shmuel
authors.initials: S
authors.lastname: Evron
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D011446:Prospective Studies; D012107:Research Design; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult