Abstract
Purpose
To compare the efficacy of the ProSeal LMA™ and SLIPA™ supralaryngeal airways (SLA) with the standard tracheal tube (TT) in 150 consecutive day-case laparoscopic gynecological surgery procedures requiring general anesthesia.
Methods
One hundred and fifty patients were randomized into three groups. An identical general anesthesia technique was used in all patients apart from the addition of muscle relaxants and reversal drugs in the TT group. Patients were excluded if there were risk factors for gastroesophageal reflux. Ease of use, quality of seal, ventilation, systolic pressure, response to intubation, side effects and operating room time were assessed.
Results
Both ProSeal LMA™ and SLIPA™ were easy to insert (100% success) and ventilate with respective mean (standard deviation) maximum sealing pressures of 31 (4.6) and 30 (5.2) cmH2O (P = 0.4) with no muscle relaxants. The seal quality in both ProSeal LMA™ and SLIPA™ permitted the use of low flows, 485 (291) and 539 (344) mL·min-1 (P = 0.2) respectively, although in the TT group significantly lower flows [377 (124) mL·min-1], (P < 0.01) were achieved. Systolic pressure in the SLA groups was more stable in response to insertion than in the TT. With ProSeal™ there was a lower incidence of sore throats than with TT (30% vs 57%), (P < 0.05), but there was a lesser difference as compared with SLIPA™ (30% vs 49%), (P > 0.05). With both SLAs, there was a significant reduction in operating room time (> three minutes), (P < 0.001).
Conclusions
These results suggest that the ProSeal LMA™ (reusable) and SLIPA™ (single-use) SLAs were easy to use without requiring muscle relaxants, and reduce operating room time compared to the TT technique in day case laparoscopies.
Résumé
Objectif
Comparer ľefficacité des canules supralaryngées (CSL) ProSeal LMA™et SLIPA™avec celle du tube endotrachéal (TET) régulier dans 150 interventions gynécologiques laparoscopiques consécutives nécessitant une anesthésie générale.
Méthode
Nous avons réparti 150 patientes au hasard en trois groupes. La même technique ďanesthésie générale a été appliquée chez toutes, sauf ľaddition de myorelaxants et de contre-myorelaxants avec le TET. Certaines ont été exclues s’il y avait des risques de reflux gastro-œsophagien. La facilité ďutilisation, ľétanchéité, la ventilation, la tension artérielle systolique, la réaction à ľintubation, les effets secondaires et le temps en salle ďopération ont été évalués.
Résultats
Ľinsertion des ProSeal LMA™ et SLIPA™ (100 % de succès) et la ventilation ont été faciles avec une moyenne respective (écart type) maximale de pression ďétanchéité de 31 (4,6) et 30 (5,2) cmH2O (P = 0,4) sans myorelaxants. La bonne étanchéité des ProSeal LMA™ et SLIPA™ a permis ďutiliser de faibles débits, respectivement de 485 (291) et 539 (344) mL·min-1 (P = 0,2), et significativement plus bas [377 (124) mL·min-1], (P < 0,01) avec le TET. La tension systolique chez les patients des groupes CSL, comparés au groupe TET, a été plus stable en réaction à ľinsertion de la canule. Avec le ProSeal™, comparé au TET, il y a eu une incidence plus faible de mal de gorge (30 % vs 57 %), (P < 0,05), et une plus petite différence avec le SLIPA™ (30 % vs 49 %), (P > 0,05). Avec les CSL, le temps en salle ďopération a été significativement réduit (> trois minutes), (P < 0,001).
Conclusion
Ces résultats montrent que, pour des laparoscopies, les CSL ProSeal LMA™ (réutilisable) et SLIPA™ (jetable) ont été faciles à utiliser sans nécessiter de myorelaxants et qu’ils réduisent le temps de salle ďopération comparativement au TET.
Article PDF
Similar content being viewed by others
References
Miller DM, Light D. Laboratory and clinical comparisons of the Streamlined Liner of the Pharynx Airway (SLIPA) with the laryngeal mask airway. Anaesthesia 2003; 58: 136–42.
Williams MT, Rice I, Ewen SP, Elliott SM. A comparison of the effect of two anaesthetic techniques on surgical conditions during gynaecological laparoscopy. Anaesthesia 2003; 58: 574–8.
Piper SN, Triem JG, Rohm KD, Maleck WH, Schollhorn TA, Boldt J. ProSeal-laryngeal mask versus endotracheal intubation in patients undergoing gynaecologic laparoscopy. Anasthesiol Intensivmed Notfallmed Schmerzther 2004; 39: 132–7.
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.
Hein C, Plummer J, Owen H. Evaluation of the SLIPA™ (Streamlined LIner of the Pharynx Airway), a single use supraglottic airway device, in 60 anaesthetised patients undergoing minor surgical procedures. Anaesth Intensive Care 2005; 33: 571–7.
Maltby JR, Beriault MT, Watson NC, Liepert D, Fick GH. The LMA-ProSeal is an effective alternative to tracheal intubation for laparoscopic cholecystectomy. Can J Anesth 2002; 49: 857–62.
Juvin P, Fevre G, Merouche M, Vallot T, Desmonts JM. Gastric residue is not more copious in obese patients. Anesth Analg 2001; 93: 1621–2.
Maltby JR, Pytka S, Watson NC, McTaggart Cowan RA, Fick GH. Drinking 300 mL of clear fluid two hours before surgery has no effect on gastric fluid volume and pH in fasting and non-fasting obese patients. Can J Anesth 2004; 51: 111–5.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Miller, D.M., Camporota, L. Advantages of ProSeal™ and SLIPA™ airways over tracheal tubes for gynecological laparoscopies. Can J Anesth 53, 188–193 (2006). https://doi.org/10.1007/BF03021826
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03021826