Less perilaryngeal gas leakage with SLIPA™ than with LMA-ProSeal™ in paralyzed patients.
OBJECTIVE
The aim of this study was to compare the Streamlined Liner of the Pharynx Airway (SLIPA™) with the ProSeal Laryngeal Mask Airway (LMA-ProSeal™) in mechanically ventilated paralyzed patients undergoing laparoscopic gynecologic surgery.


METHODS
One hundred and one patients were allocated randomly to SLIPA (n = 50) or to LMA-ProSeal (n = 51) treatment groups. After induction of general anesthesia and insertion of the assigned supralaryngeal airway (SLA) device, we made note of the occurrence of any gastric insufflation and perilaryngeal leakage. We then evaluated the anatomical fit of the SLA device using a fibreoptic bronchoscope, and we assessed the airway sealing pressure and respiratory mechanics with change in head position and during peritoneal insufflation. After surgery, we evaluated the severity of postoperative sore throat and the presence of blood or regurgitated fluid on the SLA device.


RESULTS
The insertion success rate, gastric insufflation, perilaryngeal leakage, anatomical fit, airway sealing pressure, respiratory mechanics, severity of sore throat, and incidence of blood and regurgitated fluid on the device were similar between the two groups. The incidence of perilaryngeal leakage with changes in the patient's head position was lower with the SLIPA group than with the LMA-ProSeal group (3/50 vs 11/51, respectively; P = 0.026). During peritoneal insufflation, perilaryngeal leakage did not occur with the SLIPA but occurred in four cases with the LMA-ProSeal (P = 0.045).


CONCLUSIONS
Both the SLIPA and the LMA-ProSeal can be used effectively and without severe complications in paralyzed patients undergoing laparoscopic gynecological surgery. However, the SLIPA offers the advantage of less perilaryngeal gas leakage than the LMA-ProSeal with change in head position and during insufflation of the peritoneal cavity. This trial is registered with ANZCTR (ACTRN12609000914268).
Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, 224-1 Heukseok-dong, Dongjak-gu, Seoul, 156-755, Korea.
Young Cheol
YC
Woo
Su Man
SM
Cha
Hyun
H
Kang
Chong Wha
CW
Baek
Yong Hun
YH
Jung
Jin Yun
JY
Kim
Gill Hoi
GH
Koo
Sun Gyoo
SG
Park
Seong Deok
SD
Kim
D000328:Adult; D001999:Bronchoscopy / Q000379:methods; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005336:Fiber Optic Technology; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D017214:Laryngeal Masks / Q000009:adverse effects*; D008875:Middle Aged; D010243:Paralysis / Q000150:complications*; D010529:Peritoneal Cavity; D010612:Pharyngitis / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D011187:Posture; D012121:Respiration, Artificial; D015656:Respiratory Mechanics; D012720:Severity of Illness Index; D055815:Young Adult