European Journal of Molecular & Clinical Medicine

Abstract

The cuffed endo tracheal tube was considered as the gold standard for provision of a safe glottic seal, especially for laparoscopic procedures under general anaesthesia. Proseal laryngeal mask airway (PLMA) has a dorsal cuff, in addition to the peripheral cuff of LMA, pushing the mask anterior providing a better seal around the glottic aperture and permitting high airway pressures without leak. The drain tube which lies parallel to the ventilation tube allows drainage of passively regurgitated gastric secretions away from the airway and serves as a passage for the gastric tube.
Objectives:  Primary Objective:  To compare LMA-Proseal with Endotracheal Tube for ease of insertion.  Secondary Objective:  To compare LMA-Proseal with Endotracheal Tube with regard tohaemodynamic changes in patients undergoing laparoscopic surgeries under general anaesthesia.
Methodology: In this Hospital based prospective observational study,sixty ASA PS 1 or 2 patients requiring laparoscopic surgeries were allocated into two groups, 30 each (n=30) based on the technique of ventilation, either using LMA-Proseal or ETT. Prior to induction, patient and airway characteristics were recorded. The primary outcome was the ease of insertion, which was defined in terms of number of attempts and time for insertion.
Results: In this study, the ease of insertion of LMA-Proseal was comparable to ETT. Both were of 100% single insertion and time taken for insertion was 16±2SD for LMA-Proseal and 16±2.5SD for ETT. The hemodynamic changes were found to be more with ETT than LMA-Proseal. Oxygenation and ventilation were maintained in both groups. Success rate of first attempt insertion (group P 86.7% and group E 76.7%) and time taken for insertion of Ryle’s tube were less with LMA-Proseal (p value 0.002).
Conclusion: This present study suggests that the use of LMA-Proseal for ventilation in patients undergoing laparoscopic surgeries under general anaesthesia is better compared to ETT. The ease of insertion was comparable and hemodynamic responses were less than with ETT.