Comparison of Supreme Laryngeal Mask Airway and ProSeal Laryngeal Mask Airway during Cholecystectomy

Abstract

Objective: This study compared the safety and efficacy of the Supreme Laryngeal Mask Airway (S-LMA) with that of the ProSeal-LMA (P-LMA) in laparoscopic cholecystectomy. Material and Methods: Sixty adults were randomly allocated. Following anaesthesia induction, experienced LMA users inserted the airway devices. Results: Oropharyngeal leak pressure was similar in groups (S-LMA, 27.8±2.9 cmH20; P-LMA, 27.0±4.7 cmH20; p=0.42) and did not change during the induction of and throughout pneumoperitoneum. The first attempt success rates were 93% with both S-LMA and P-LMA. Mean airway device insertion time was significantly shorter with S-LMA than with P-LMA (12.5±4.1 seconds versus 15.6±6.0 seconds; p=0.02). The first attempt success rates for the drainage tube insertion were similar (P-LMA, 93%; S-LMA 100%); however, drainage tubes were inserted more quickly with S-LMA than with P-LMA (9.0±3.2 seconds versus 14.7±6.6 seconds; p=0.001). In the PACU, vomiting was observed in five patients (three females and two males) in the S-LMA group and in one female patient in the P-LMA group (p=0.10). Conclusion: Both airway devices can be used safely in laparoscopic cholecystectomies with suitable patients and experienced users. However, further studies are required not only for comparing both airway devices in terms of postoperative nausea and vomiting but also for yielding definitive results. Turkish Anahtar Kelimeler: Laparaoskopik kolesistektomi, supraglottik havayolu gereçleri, laringeal maske havayolu, proseal, supreme Amaç: Bu çalışmada laparoskopik kolesistektomide Supreme Laringeal Maske Havayolu (S- LMA) ve Proseal Laringeal Maske Havayolunun (P-LMA) güvenilirliği ve etkinliği karşılaştırılmıştır. Meteryal metod: 60 yetişkin hasta rastgele seçildi. Anestezi indüksiyonunu takiben, tecrübeli LMA kullanıcıları tarafından hava yolu gereçleri yerleştirildi. Bulgular: Orofarengeal kaçak basınçları iki grupta da benzerdi (S-LMA, 27.8±2.9 cmH20; P-LMA, 27.0±4.7 cmH20; p=0.42) ve pnömoperitonum başlangıcında ve pnömoperitonum süresince değişmedi. İlk denemede yerleştirme başarısı S-LMA ve P-LMA ile %93 idi. Ortalama hava yolu gereci yerleştirme süresi, S- LMA ile P-LMA dan anlamlı olarak daha kısaydı. (12.5±4.1 saniye, 15.6±6.0 saniye; p=0.02). Drenaj tüpünü ilk denemede yerleştirme başarısı benzer olmasına rağmen ( P-LMA %93; S- LMA %100), S-LMA da drenaj tüpü P-LMA dan daha kısa sürede yerleştirildi (9.0±3.2 saniye, 14.7±6.6 saniye; p=0.001). Anestezi sonrası bakım ünitesinde, S- LMA grubunda 5 hastada (3 kadın, 2 erkek), P-LMA grubunda ise 1 kadın hastada kusma gözlendi (p=0.10). Sonuç: Her iki havayolu gereci de uygun hasta ve deneyimli uygulayıcılarla laparoskopik kolesistektomide güvenli bir şekilde kullanılabilir. Ancak her iki havayolu gerecini hem postoperatif bulantı ve kusma yönünden karşılaştıran hem de kesin sonuçlar veren çalışmalar gerekmektedir.

Keywords

• Laparoscopic cholecystectomy, supraglottic airway devices, laryngeal mask airway, proseal, supreme

Comparison of Supreme Laryngeal Mask Airway and ProSeal Laryngeal Mask Airway during Cholecystectomy

Öz

References

1. Van Zundert A, Brimacombe J. The LMA Supreme--a pilot study. Anaesthesia 2008;63:209-10. [CrossRef]
2. Verghese C, Ramaswamy B. LMA-Supreme - a new single-use LMA with gastric access: a report on its clinical efficacy. Br J An- aesth 2008;101:405-10. [CrossRef]
3. Hosten T, Gurkan Y, Ozdamar D, Tekin M, Toker K, Solak M. A new supraglottic airway device: LMA-Supreme, comparison with LMA- Proseal. Acta Anaesthesiol Scand 2009;53:852-7. [CrossRef]
4. Seet E, Rajeev S, Firoz T, Yousaf F, Wong J, Wong DT, et al. Safety and efficacy of laryngeal mask airway Supreme versus laryngeal mask airway ProSeal: a randomized controlled trial. Eur J Anaes- thesiol 2010;27:602-7. [CrossRef]
5. Eschertzhuber S, Brimacombe J, Hohlrieder M, Keller C. The la- ryngeal mask airway Supreme: a single use laryngeal mask airway with an oesophageal vent. A randomized, cross-over study with the laryngeal mask airway ProSeal in paralysed, anaesthetised patients. Anaesthesia 2009;64:79-83. [CrossRef]
6. 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;82:286-7. [CrossRef]
7. Maltby JR, Beriault MT, Watson NC, Liepert D, Fick GH. The LMA- ProSeal is an effective alternative to tracheal intubation for laparo- scopic cholecystectomy. Can J Anaesth 2002;49:857-62. [CrossRef]
8. Lu PP, Brimacombe J, Yang C, Shyr M. ProSeal versus the Classic laryngeal mask airway for positive pressure ventilation during lapa- roscopic cholecystectomy. Br J Anaesth 2002;88:824-7. [CrossRef]

9. Lee AK, Tey JB, Lim Y, Sia AT. Comparison of the single-use LMA supreme with the reusable ProSeal LMA for anaesthesia in gynaecological laparoscopic surgery. Anaesth Intensive Care 2009;37:815-9.
10. Beleña JM, Gracia JL, Ayala JL, Nşñez M, Lorenzo JA, de los Reyes A, et al. The Laryngeal Mask Airway Supreme for positive pressure ventilation during laparoscopic cholecystectomy. J Clin Anesth 2011;23:456-60. [CrossRef]
11. Abdi W, Amathieu R, Adhoum A, Poncelet C, Slavov V, Kamoun W, et al. Sparing the larynx during gynecological laparoscopy: a randomized trial comparing the LMA Supreme and the ETT. Acta Anaesthesiol Scand 2010;54:141-6. [CrossRef]
12. Zhang L, Seet E, Mehta V, Subramanyam R, Ankichetty SP, Wong DT, et al. Oropharyngeal leak pressure with the laryngeal mask airway Supreme™ at different intracuff pressures: a randomized controlled trial. Can J Anaesth 2011;58:624-9. [CrossRef]
13. Lumb AB, Wrigley MW. The effect of nitrous oxide on larynge- al mask cuff pressure: in vitro and in vivo studies. Anaesthesia 1992;47:320-3. [CrossRef]
14. Brain AI, Verghese C, Strube PJ. The LMA ‘ProSeal’-a laryngeal mask with an oesophageal vent. Br J Anaesth 2000;84:650-4. [CrossRef]
15. Gaitini LA, Vaida SJ, Somri M, Yanovski B, Ben-David B, Hagberg CA. A randomized controlled trial comparing the ProSeal Laryn- geal Mask Airway with the Laryngeal Tube Suction in mechanically ventilated patients. Anesthesiology 2004;101:316-20. [CrossRef]
16. Whitford JHW, Gunstone AJ. Gastric perforation: a hazard of laparos- copy under general anaesthesia. Br J Anaesth 1972;40:97-9. [CrossRef]
17. Reynolds RC, Pauca AL. Gastric perforation, an anaesthesia-induced hazard in laparoscopy. Anesthesiology 1973;38:84-5. [CrossRef]