Comparative study of ProSeal laryngeal mask airway and endotracheal tube in patients undergoing laparoscopic surgeries under general anaesthesia

Authors

  • Afra Shibin Department of Anaesthesiology, Yenepoya Medical College, Deralakatte, Mangalore, Karnataka, India
  • Amrutha Priyamkari Department of Anaesthesiology, Yenepoya Medical College, Deralakatte, Mangalore, Karnataka, India
  • Habib Rahaman A. A. Department of Anaesthesiology, Yenepoya Medical College, Deralakatte, Mangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20223651

Keywords:

ProSeal laryngeal mask airway, ETT, Supraglottic airway devices, Laparoscopic surgery

Abstract

Background: Supra glottic airway devices (SGAD) is integral to airway management during general anesthesia. PLMA, a second-generation SGAD with a gastric channel and an efficient seal, is an alternative for the COETT, which is the gold standard for securing the airway.

SGAD has the advantage of lesser hemodynamic changes during insertion and removal. This study aimed to compare the hemodynamic and ventilatory changes between PLMA and the endotracheal tube (ETT).

Methods: Prospective randomized study, conducted at Yenepoya medical college hospital on 90 patients undergoing elective laparoscopic surgeries under general Anaesthesia. The patients were divided into groups; group p=45 patients (PMLA) and E=45 patients (COETT). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), peripheral oxygen saturation (SpO2) and end-tidal carbon dioxide (EtCO2) were documented at baseline, at 1, 3, 5 and 8 minutes after placement of airway device.

Results: Differences in vital parameters at baseline were statistically insignificant. HR, SBP, DBP and MAP were significantly higher in group E compared to group P at 1st, 3rd, 5th and 8 min after the insertion of the airway device. There was no statistically significant difference in SpO2 and EtCO2. Post-extubation laryngopharyngeal morbidity was noted in 5 patients with ETT compared to 1 patient with PMLA.

Conclusions: PLMA provides better hemodynamic stability at insertion when compared to ETT. Both PLMA and ETT provide good oxygenation and ventilation during elective laparoscopic surgeries. Insertion at first attempt was more successful with PLMA when compared to ETT.

Author Biography

Afra Shibin, Department of Anaesthesiology, Yenepoya Medical College, Deralakatte, Mangalore, Karnataka, India

DR. AFRA SHIBIN

3RD YEAR RESIDENT 

DEPT OF ANESTHESIOLOGY, YENEPOYA MEDICAL COLLEGE HOSPITAL, DERLAKATTE, MANGALORE 

References

Talke P. The Effectof tracheal intubation induced autonomic response on Photoplethysography. Anaesthesiology Res Pract. 2017;10:1155.

Teong CY, Huang C, Sun F. The Haeodynamic Response to Endotracheal Intubation at different Time of Fentanyl Given During Induction : A Randomised Controlled Trial. Sci Rep. 2020;10:8829.

Brain A, Verghese C, Strube V. The PLMA-a laryngel mask with an oesophageal lent Br. J Anasthesia. 2000;84:650-4.

Keller C, Brima Combe J. Mucosal pressure and oropharyngeal leak pressure with the PLMA versus CLMA in Anaesthetized paralyzed patients. Br J Anaesth. 2000;85(2):262-6.

LMA-ProSeal Instruction Manual. 2002.

Myatra SN, Khandale V, Pühringer F, Gupta S, Solanki SL, Divatia J V. A novel technique for insertion of ProSealTM laryngeal mask airway: Comparison of the stylet tool with the introducer tool in a prospective, randomised study. Indian J Anaesth. 2017;61(6):475-81.

Drage MP, Nunez J, Vaughan RS, Asai T. Jaw thrusting as a clinical test to assess the adequate depth of anaesthesia for insertion of the laryngeal mask. Anaesthesia. 1996;51(12):1167-70.

Howath A, Brimacombe J, Keller C. Gum-elastic bougie-guided insertion of the ProSeal laryngeal mask airway: a new technique. Anaesth Intensive Care. 2002;30(5):624-7.

O’Connor CJJ, Davies SR, Stix MS. “Soap bubbles” and “gauze thread” drain tube tests. Anesthesia and analgesia. United States; 2001;(93):1082.

Ramaiah R, Das D, Bhananker SM, Joffe AM. Extraglottic airway devices: A review. Int J Crit Illn Inj Sci. 2014;4(1):77-87.

Stix MS, O’Connor Jr CJ. Depth of insertion of the ProSealTM laryngeal mask airway. BJA Br J Anaesth. 2003;90(2):235-7.

O’Connor CJJ, Stix MS. Bubble solution diagnoses ProSeal insertion into the glottis. Anesthesia and analgesia. United States. 2002;(94):1671-2.

Brimacombe J, Keller C, Berry A, Mitchell S. Assessing ProSeal Laryngeal Mask Positioning: The Suprasternal Notch Test. Anesth Analg. 2002;94(5):1375.

Cook TM, Lee G, Nolan JP. The ProSealTM laryngeal mask airway: a review of the literature. Can J Anesth. 2005;52(7):739.

Brimacombe J, Irving S, Keller C. Ease Placement of LMA ProSeal with a Gastric Tube Inserted: In Response. Anesth Analg. 2004;98(6).

Lardner DRR, Cox RG, Ewen A, Dickinson D. Comparison of laryngeal mask airway (LMA)-ProSeal and the LMA-Classic in ventilated children receiving neuromuscular blockade. Can J Anaesth. 2008;55(1):29-35.

Goldmann K, Jakob C. Size 2 ProSealTM laryngeal mask airway: a randomized, crossover investigation with the standard laryngeal mask airway in paediatric patients. Br J Anaesth. 2005;94(3):385-9.

Saraswat N, Kumar A, Mishra A, Gupta A, Saurabh G, Srivastava U. The comparison of ProSeal laryngeal mask airway and endotracheal tube in patients undergoing laparoscopic surgeries under general anaesthesia. Indian J Anaesth. 2011;55:129-34.

Kannan S, Harsoor S, Sowmiya L, Nethra S, Devika R, Sathesha M. Comparison of ventilator efficacy and airway dynamics between ProSeal laryngeal mask airway and endotracheal tube in adult patients during general anesthesia. J Anaesthesiol Clin Pharmacol. 2015;31:517-21.

Malaviya P, Manish SK, Summit K, Yadav KD, Mishra LS. A Comparison of General Anaesthesia Techniques Using ProSeal Laryngeal Mask Airway or Endotracheal Tube, In Patients Undergoing Laproscopic Surgery”. IOSR J Dent Med Sci. 2016;15:01-7.

Parikh S, Parekh S, Doshi C, Vyas V. ProSeal laryngeal mask airway versus cuffed endotracheal tube for laparoscopic surgical procedures under general anesthesia: A random comparative study. Anesth Essays Res. 2017;11(4):958-63.

Manish SK, Sumit K, Dharmendra YK. “A Comparison of General Anaesthesia Techinques Using ProSeal Laryngeal Mask Airway or Endotracheal Tube, In Patients Undergoing Laproscopic Surgery". J Dent Med Sci. 2016;15(09):01-7.

Patodi V, Singh M, Sethi S, Depal V, Jain N, Kumar V. A comparative study between ProSeal laryngeal mask airway and endotracheal tube for ease of insertion and haemodynamic changes in patients undergoing laparoscopic cholecystectomy under general anaesthesia. Int J Res Med Sci. 2016;4:5334-40.

Shah K. ProSeal laryngeal mask airway as an alternative to standard endotracheal tube in securing upper airway in the patients undergoing beating-heart coronary artery bypass grafting. Ann Card Anaesth. 2017;20(1):61-6.

Kapoor D, Jindal S, Gombar S, Bajaj N, Atter P, Dalal U. Comparative Evaluation of ProSeal LMA vs. Cuffed Endotracheal Tube in Patients Undergoing Laparoscopic Cholecystectomy under General Anesthesia. Arch Anesthesiol Crit Care. 2018;4:4.

Gupta R, Mahajan R, Jatinder M, Gulati S, Mehta A, Nazir R. A comparison between ProSeal laryngeal mask airway and Air-Q Blocker in patients undergoing elective laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2019;35(3):340-7.

Patel AS, Jain N. Comparison of ProSeal laryngeal mask airway, classical laryngeal mask airway with endotracheal tube in gynecological laparoscopy under controlled ventilation. Int J Adv Med. 2019;6(1):81-6.

Bhardwaj DV. Randomized comparative study between ProSeal laryngeal mask airway (PLMA) and Endotracheal tube (ETT) for airway management in laparoscopic cholecystectomy under general anesthesia. J Med Sci Clin Res. 2019;7(12):330-9.

Patodi V, Singh M, Sethi S, Depal V, Jain N, Kumar V. A comparative study between ProSeal laryngeal mask airway and endotracheal tube for ease of insertion and haemodynamic changes in patients undergoing laparoscopic cholecystectomy under general anaesthesia. Int J Res Med Sci. 2016;5334-40.

Piper SN, Triem JG, Röhm KD, Maleck WH, Schöllhorn TAH, Boldt J. ProSeal-laryngeal mask versus endotracheal intubation in patients undergoing gynaecologic laparoscopy. Anasthesiol Intensivmed Notfallmed Schmerzther. 2004;39(3):132-7.

Jamwal S, Bhardwaj V, Singh V, Kaur R. Randomized comparative study between ProSeal laryngeal mask airway (PLMA) and Endotracheal tube (ETT) for airway management in laparoscopic cholecystectomy under general anesthesia. J Med Sci Clin Res. 2019;7(12):330-9.

Idrees A, Khan FA. A comparative study of positive pressure ventilation via laryngeal mask airway and endotracheal tube. J Pak Med Assoc. 2000;50(10):333-8.

Shroff P, Kamath S. Randomized Comparative Study Between The ProSeal Laryngeal Mask Airway And The Endotracheal Tube For Laparoscopic Surgery. Internet J Anesthesiol. 2006;11(1):1-5.

Parikh S, Parekh S, Doshi C, Vyas V. ProSeal laryngeal mask airway versus cuffed endotracheal tube for laparoscopic surgical procedures under general anesthesia: A random comparative study. Anesth Essays Res. 2017;11(4):958-63.

Sharma B, Sood J, Sahai C, Kumra V. Efficacy and safety performance of ProSeal Laryngeal Mask Airway in Laparoscopic surgery: Experience of 1000 cases. Indian J Anesth. 2008;52(3):288-96.

Lim Y, Goel S, Brimacombe JR. The ProSeal laryngeal mask airway is an effective alternative to laryngoscope-guided tracheal intubation for gynaecological laparoscopy. Anaesth Intensive Care. 2007;35(1):52-6.

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Published

2022-12-30

How to Cite

Shibin, A., Priyamkari, A., & A. A., H. R. (2022). Comparative study of ProSeal laryngeal mask airway and endotracheal tube in patients undergoing laparoscopic surgeries under general anaesthesia. International Journal of Research in Medical Sciences, 11(1), 277–283. https://doi.org/10.18203/2320-6012.ijrms20223651

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Original Research Articles