European Journal of Molecular & Clinical Medicine

Most of the studies using Proseal Laryngeal Mask Airway (PLMA) have used Volume Controlled Mode as ventilation mode. Although pressure-controlled (PC) ventilation potentially provides greater control over airway pressure by virtue of its decelerating inspiratory flow pattern, it remains a relatively less frequently used ventilation strategy. Thus, we aimed to compare the hemodynamic changes, ventilation changes, while using PLMA and Endotracheal tube (ETT) in PC ventilation among patients undergoing laparoscopic surgeries. Based on inclusion – exclusion criteria, 50 patients were enrolled and socio-demographic data was collected in a pre-designed proforma. Patients were then randomly allocated to receiving PLMA or ETT and haemodynamic variables, ventilatory variables, ease of insertion and postoperative complications were compared. Demographic profile of the study groups was comparable. The insertion characteristics of PLMA is like that of ETT while PLMA facilitates easy insertion of gastric tube. Mean Arterial Pressure (MAP) had a significant difference between two groups at one minute, three minutes and when measured after extubation. Patients on PLMA had significantly lesser MAP compared to the ETT group. PLMA was able to provide adequate ventilation using similar peak inspiratory pressure and tidal volume similar to that ETT in PC ventilation. Significant differences were observed in postoperative morbidities as well with PLMA having significantly less sore throat and dysphagia. Thus, we conclude that in short duration surgeries, PLMA can be used as it provides adequate ventilation using similar peak inspiratory pressure and tidal volume like that of ETT when used in PC mode of ventilation.

Background: This study compared two insertion techniques of Proseal LMA.
Method: After institutional ethics committee approval and patients consent, 100 women aged 18-60 years of ASA 1 & 2 were included in the study. We have excluded patients with known or predicted difficult airway, recent sore throat, mouth opening less than 2.5cm and with risk of aspiration (nonfasted or gastroesophageal reflux). Patients were divided into 2 groups of 50 each.
In Group A-Digital Technique for PLMA Insertion & in Group B- Rotational Technique for PLMA Insertion was used. Using chi-square test and student t-test statistical results were obtained.
Results: The insertion success rate at the first attempt was higher for the rotational technique than the standard technique. Insertion technique made no difference in insertion time. Blood on PLMA after removal less in the rotation technique. Sore throat at 1 hr and 24 hrs post-surgery less in the in the rotation technique than the standard technique.
Conclusion: We conclude that insertion of the PLMA is more successful with the rotation technique in comparison with standard technique of insertion.