title: Comparison of Laryngeal Mask Airway Supreme and Laryngeal Mask Airway Proseal with respect to oropharyngeal leak pressure during laparoscopic cholecystectomy:  a randomised controlled trial.
abstract: BACKGROUND
  A comparison of the efficacy and safety of the Laryngeal Mask Airway (LMA) Supreme (LMAS) versus the LMA Proseal (LMAP) in elective laparoscopic cholecystectomy.
  
  
  OBJECTIVE
  To compare the LMAS with LMAP in terms of ventilatory efficacy, airway leak pressure (airway protection), ease-of-use and complications.
  
  
  METHODS
  Prospective, single-blind, randomised, controlled study.
  
  
  METHODS
  The Hospital del Sureste and Hospital Ramon y Cajal, Madrid, between May 2009 and March 2011. The Hospital del Sureste is a secondary hospital and Hospital Ramon y Cajal is a tertiary hospital.
  
  
  METHODS
  Patients undergoing elective laparoscopic cholecystectomy were studied following informed consent. Inclusion criteria were American Society of Anesthesiologists physical status I to III and age 18 or more. Exclusion criteria were BMI more than 40 kg m, symptomatic hiatus hernia or severe gastro-oesophageal reflux.
  
  
  METHODS
  Anaesthesiologists experienced in the use of LMAP and LMAS participated in the trial. One hundred twenty-two patients were randomly allocated to LMAS or LMAP.
  
  
  METHODS
  Our primary outcome measure was the oropharyngeal leak pressure (OLP). Secondary outcomes were the time and number of attempts for insertion, ease of insertion of the drain tube, adequacy of ventilation and the incidence of complication. Patients were interviewed postoperatively to evaluate the presence of sore throat, dysphagia or dysphonia.
  
  
  RESULTS
  Two patients were excluded when surgery changed from laparoscopic to open. A total of 120 patients were finally included in the analysis. The mean OLP in the LMAP group was significantly higher than that in the LMAS group (30.7 ± 6.2 versus 26.8 ± 4.1 cmH2O;P < 0.01). This was consistent with a higher maximum tidal volume achieved with the LMAP compared to the LMAS (511 ± 68 versus 475 ± 55 ml; P = 0.04). The success rate of the first attempt insertion was higher for the LMAS group than the LMAP group (96.7 and 71.2%, respectively; P < 0.01). The time taken for insertion, ease of insertion of the drain tube, complications and postoperative pharyngolaryngeal adverse events were similar in both groups.
  
  
  CONCLUSIONS
  The LMAP has a higher OLP and achieves a higher maximum tidal volume compared to the LMAS, in patients undergoing elective laparoscopic cholecystectomy. The success of the first attempt insertion was higher for the LMAS.
authors: Department of Anaesthesiology and Critical Care, Hospital Universitario del Sureste, Arganda del Rey, Valdemoro, Madrid, Spain. josemariabelena@yahoo.es
authors: José M
authors: JM
authors: Beleña
authors: Mónica
authors: M
authors: Núñez
authors: Diego
authors: D
authors: Anta
authors: Maria
authors: M
authors: Carnero
authors: José L
authors: JL
authors: Gracia
authors: José L
authors: JL
authors: Ayala
authors: Raquel
authors: R
authors: Alvarez
authors: Javier
authors: J
authors: Yuste
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D000776:Anesthesiology / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D017214:Laryngeal Masks / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D016037:Single-Blind Method; D013990:Tidal Volume; D016896:Treatment Outcome