Proseal Laryngeal Mask Airway v/s Endotracheal Intubation for Gynaecological Laparoscopic Surgeries
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2019, Vol 6, Issue 4
Abstract
Background: Proseal LMA (PLMA), is the latest entrant in the family of LMA designed for positive pressure ventilation and protection against aspiration. These features of PLMA is especially useful in laparoscopy surgeries, which is widely preferred these days and can act as an alternative to Endotracheal tube (ETT). Rigid laryngoscopy during endotracheal intubation (gold standard for safe glottic seal) causes haemodynamic responses which adds to the stress of pneumoperitoneum in laparoscopic surgeries, unlike Proseal LMA which is a supraglottic device and less invasive. Aim: To compare the efficacy and safety of Proseal Laryngeal Mask Airway with Portex endotracheal intubation in gynaecological laparoscopic surgeries under general anesthesia. Setting and Design: A prospective, randomised study was conducted in 60 females, ASA-I & ASA-II patients undergoing laparoscopic gynaecological surgery under general anesthesia. Ethical clearance and written consent was obtained before the study. Patients were randomly divided into two groups-PLMA (P) and Endotracheal tube (E) depending on the device used to secure airway. Ease, attempt of of insertion, haemodynamic parameters and postoperative complications were studied. Results: Insertion rate was 100% in both the groups. Vital parameters like heart rate, systolic bp, diastolic bp and mean arterial pressure were relatively lower with Proseal LMA at 1 min, 3 min and 5 min and after removal as compared to ETT. The difference was statistically significant. There was no significant difference in End tidal CO2, SpO2, during baseline, insertion and removal of device, before and after pneumoperitoneum, also in airway pressure during insertion, before and after pneumoperitoneum. Perioperative complication was higher with endotracheal tube. Conclusion: The Proseal LMA offers a safe and effective alternative for airway management in patients undergoing gynaecological laparoscopic procedures under general anesthesia.
Authors and Affiliations
Amruta Changdeo Patil
Keywords
Related Articles
- EP ID EP667867
- DOI 10.21088/ijaa.2349.8471.6419.31
- Views 132
- Downloads 0
Comparative Evaluation of two Different Intravenous Doses of Midazolam to Aid the Insertion of LMA Classic as Adjuvants to Propofol Anaesthesia
Background: Propofol is a widely accepted medication for the uccessful insertion of laryngeal mask airway, but as a sole induction agent, it has a very low success rate. A number of co-induction agents have been used w...
Comparative Evaluation of Intraocular Pressure after Various Intravenous Inducing Agents
Background: General anaesthesia has effects on various systems including intraocular pressure (IOP). Anaesthetic drugs also lead to changes in IOP. Though rare, IOP measurement is important as acute glaucoma is a major c...
A Comparative Study of Effect of Short-term Sedation of Post-operative Mechanically Ventilated Patients with Dexmedetomedine and Propofol
Background and Objectives: Post-operative mechanically ventilated patient in the intensive care unit (ICU) frequently need sedation and analgesia to facilitate care. Inadequate Sedation in patients admitted to the ICU af...
Clonidine as an Adjuvant to Ropivacaine in Brachial Plexus Block
Regional blocks are gaining popularity to perform surgery by blocking an isolated part of the body. Trauma is one of the consequences of this fast moving world. To deal with the surgeries related to upper limb, brachial...
Pain on Injection: Comparison between Propofol LCT vs Propofol MCT-LCT
Background and Aims: Propofol is widelyused for induction andmaintenance of anaesthesia. It has the disadvantage of causing sharp pain on injection which can interfere with smooth induction of anaesthesia. The aim of the...