Comparison of LM-Supreme™ and endotracheal tube in patients undergoing gynecological laparoscopic surgery
- 12 Downloads
While laryngeal mask is widely used for laparoscopic interventions in some countries, concerns exist regarding pulmonary aspiration and inadequate ventilation. We compared the LM-Supreme™ (LM-S) with the endotracheal tube (ETT) for laparoscopic gynecological interventions in terms of ventilation parameters and gastric distention. This prospective randomized and double-blind study. The patients were divided into two groups: ETT (n = 50) and LM-S group (n = 50). All patients in the LM-S and ETT groups recieved total intravenous general anaesthesia and standard ventilation protocols. Ventilation parameters (airway peak pressure, mean airway pressure, end-tidal carbon dioxide, total volume, oropharyngeal leak pressure) and perioperative laryngopharyngeal morbidity were recorded before peritoneal insufflation, during and after the peroperative period. The mean airway pressure values in the ETT group 2 min after airway device insertion were significantly higher. The gastric distension after the laparoscope entered the abdomen in the LM-S group was found to be significantly lower. In the first hour postoperative sore throat, disphonia and dysphagia were statistically significantly higher in the ETT group. In our study we concluded that LM-S provides reliable endotracheal intubation in ASA I & II patients undergoing laparoscopic gynecological surgery under positive pressure ventilation.
ClinicalTrials.gov ID NCT02127632.
KeywordsLaryngeal mask Supreme Endotracheal tube Gynecological surgery Laparoscopy
- 3.Chmielewski C, Snyder-Clickett S. The use of the laryngeal mask airway with mechanical positive pressure ventilation. AANA J. 2004;72:347–51.Google Scholar
- 6.Belena JM, Nunez M, Gracia JL, Pérez JL, Yuste J. The Laryngeal Mask Airway Supreme TM: safety and efficacy during gynaecological laparoscopic surgery. S Afr J Anaesth Analg. 2012;18:143–7.Google Scholar
- 8.Riley RH, Williams M, Ferguson C. Preparation of Supreme laryngeal mask airway affects insertion. Anaesth Intensive Care. 2010;38:211–2.Google Scholar
- 11.Hohlrieder M, Brimacombe J, Eschertzhuber S, Ulmer H, Keller C. A study of airway management using the ProSeal LMA laryngeal mask airway compared with the tracheal tube on postoperative analgesia requirements following gynaecological laparoscopic surgery. Anaesthesia. 2007;62:913–8.CrossRefGoogle Scholar
- 18.Timmermann A, Cremer S, Eich C, Kazmaier S, Bräuer A, Graf BM, Russo SG. Prospective clinical and fiberoptic evaluation of the supreme laryngeal mask airway. Anesthesiology. 2009;110:262–5.Google Scholar
- 19.Eschertzhuber S, Brimacombe J, Hohlrieder M, Keller C. The laryngeal 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.CrossRefGoogle Scholar
- 25.Shroff P, Kamath S. Randomized comparative study between the proseal laryngeal mask airway and the endotracheal tube for laparoscopic surgery. Int J Anesthesiol. 2006;11:1.Google Scholar
- 27.Ozdamar D, Güvenç BH, Toker K, Solak M, Ekingen G. Comparison of the effect of LMA and ETT on ventilation and intragastric pressure in pediatric laparoscopic procedures. Minerva Anestesiol. 2010;76:592–9.Google Scholar
- 28.Verghese C, Brimacombe JR. Survey of laryngeal mask airway usage in 11,910 patients: safety and efficacy for conventional and nonconventional usage. Anesth Analg. 1996;82:129–33.Google Scholar
- 30.Bapat PP, Verghese C. Laryngeal mask airway and the incidence of regurgitation during gynecological laparoscopies. Anesth Analg. 1997;85:139–43.Google Scholar
- 35.Subramanian S, Sethi D. Supraglottic devices in laparoscopic surgery—a review of literature. J Anesth Clin Care. 2016;3:013.Google Scholar