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The ProSeal™ Laryngeal Mask Airway and the Laryngeal Tube Suction™ for ventilation in gynaecological patients undergoing laparoscopic surgery

Published online by Cambridge University Press:  13 April 2005

H. Roth ,
H. V. Genzwuerker ,
A. Rothhaas ,
T. Finteis  and
J. Schmeck
H. Roth
Affiliation:
University Hospital Mannheim, Institute of Anaesthesiology and Intensive Care Medicine, Faculty of Clinical Medicine Mannheim of the University of Heidelberg, Manheim, Germany
H. V. Genzwuerker
Affiliation:
University Hospital Mannheim, Institute of Anaesthesiology and Intensive Care Medicine, Faculty of Clinical Medicine Mannheim of the University of Heidelberg, Manheim, Germany
A. Rothhaas
Affiliation:
University Hospital Mannheim, Institute of Anaesthesiology and Intensive Care Medicine, Faculty of Clinical Medicine Mannheim of the University of Heidelberg, Manheim, Germany
T. Finteis
Affiliation:
University Hospital Mannheim, Institute of Anaesthesiology and Intensive Care Medicine, Faculty of Clinical Medicine Mannheim of the University of Heidelberg, Manheim, Germany
J. Schmeck
Affiliation:
University Hospital Mannheim, Institute of Anaesthesiology and Intensive Care Medicine, Faculty of Clinical Medicine Mannheim of the University of Heidelberg, Manheim, Germany
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Abstract

Summary

Background and 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 ± 6.6 s, 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.

Keywords

EQUIPMENT, masks anaesthesiaSURGERY, laparoscopyLARYNGEAL MASK AIRWAYLARYNGEAL TUBE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 2 , February 2005 , pp. 117 - 122
Copyright
2005 European Society of Anaesthesiology

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Footnotes

Results were presented in part as a poster at the 2003 Annual Meeting of the American Society of Anesthesiologists in San Francisco, USA, 12–15 October 2003.

References

Brain AI, McGhee TD, McAteer EJ, Thomas A, Abu-Saad MA, Bushman JA. The laryngeal mask airway. Development and preliminary trials of a new type of airway. Anaesthesia 1985; 40: 356–361.Google Scholar
Verghese C, Brimacombe JR. Survey of laryngeal mask airway usage in 11,910 patients: safety and efficacy for conventional and nonconventional useage. Anesth Analg 1996; 82: 129–133.Google Scholar
Weiler N, Latorre F, Eberle B, Goedecke R, Heinrichs W. Respiratory mechanics, gastric insufflation pressure, and air leakage of the laryngeal mask airway. Anesth Analg 1997; 84: 1025–1028.Google Scholar
Barker P, Langton JA, Murphy PJ, Rowbotham DJ. Regurgitation of gastric contents during general anesthesia using the laryngeal mask airway. Br J Anaesth 1992; 69: 358–360.Google Scholar
Brimacombe JR, Berry A. The incidence of aspiration associated with the laryngeal mask airway: a meta-analysis of published literature. J Clin Anesth 1995; 7: 297–305.Google Scholar
Brain AI, Verghese C, Strube PJ. The LMA ‘ProSeal’ – a laryngeal mask with an oesophageal vent. Br J Anaesth 2000; 84: 650–654.Google Scholar
Brimacombe J, Keller C. The ProSeal laryngeal mask airway: a randomized, crossover study with the standard laryngeal mask airway in paralyzed, anesthetized patients. Anesthesiology 2000; 93: 104–109.Google Scholar
Brimacombe J, Keller C. Stability of the LMA-ProSeal and standard laryngeal mask airway in different head and neck positions: a randomized crossover study. Eur J Anaesthesiol 2003; 20: 65–69.Google Scholar
Lu PP, Brimacombe J, Yang C, Shyr M. ProSeal versus the Classic laryngeal mask airway for positive pressure ventilation during laparoscopic cholecystectomy. Br J Anaesth 2002; 88: 824–827.Google Scholar
Dörges V, Ocker H, Wenzel V, Schmucker P. The laryngeal tube: a new simply airway device. Anesth Analg 2000; 90: 1220–1222.Google Scholar
Asai T, Kawashima A, Hidaka I, Kawachi S. The laryngeal tube compared with the laryngeal mask: insertion, gas leak pressure and gastric insufflation. Br J Anaesth 2002; 89: 729–732.Google Scholar
Ocker H, Wenzel V, Schmucker P, Steinfath M, Dörges V. A comparison of the laryngeal tube with the laryngeal mask airway during routine surgical procedures. Anesth Analg 2002; 95: 1094–1097.Google Scholar
Figueredo E, Martinez M, Pintanel T. A comparison of the ProSeal laryngeal mask and the laryngeal tube in spontaneously breathing anesthetized patients. Anesth Analg 2003; 96: 600–605.Google Scholar
Dörges V, Ocker H, Wenzel V, Steinfath M, Gerlach K. The Laryngeal Tube S: a modified simple airway device. Anesth Analg 2003; 96: 618–621.Google Scholar
Genzwürker H, Finteis T, Hinkelbein J, Ellinger K. First clinical experiences with the new LTS. A laryngeal tube with an oesophageal drain. Anaesthesist 2003; 52: 697–702.Google Scholar
Keller C, Brimacombe JR, Keller K, Morris R. Comparison of four methods for assessing airway sealing pressure with the laryngeal mask airway in adult patients. Br J Anaesth 1999; 82: 286–287.Google Scholar
Gaitini LA, Vaida SJ, Somri M, Ben-David B, Hagberg CA. A randomized controlled trial comparing the Proseal Laryngeal Mask Airway with the Sonda Laryngeal Tube in mechanically ventilated patients. Anesthesiology 2002; 96: A1319.Google Scholar
Carstensen S, Bein B, Claus L, Steinfath M, Dörges V. ProSeal Laryngeal Mask Airway and Laryngeal Tube S – modified airway devices for lung ventilation and gastric drainage. Anesthesiology 2003; 99: A1257.Google Scholar
Matioc AA, Arndt G. The laryngeal tube and pharyngeal mucosal pressure. Can J Anaesth 2003; 50: 525–526.Google Scholar