LMA-ProSeal™ laryngeal mask is a safe option for securing the airways for laparoscopic cholecystectomy
Authors:
Zvoníčková Dagmar; Zvoníček Václav; Klimeš Jiří; Volčík Aleš; Pelikán Karel
Authors‘ workplace:
Anesteziologicko-resuscitační klinika, LF Masarykovy univerzity a Fakultní nemocnice u sv. Anny v Brně
Published in:
Anest. intenziv. Med., 19, 2008, č. 2, s. 77-81
Category:
Anaesthesiology - Original Paper
Overview
Objective:
The aim of study was to find if LMA-ProSeal™ safely protects the airways during laparoscopic surgery.
Type of study:
Prospective study.
Setting:
Department of Anaesthesiology and Intensive Care, University Hospital.
Materials and methods:
Patients undergoing elective laparoscopic cholecystectomy were enrolled in the study. The results are presented as the median and the inter-quartile range, the statistical significance was evaluated by Mann-Whitney U Test and Wilcoxon match paired test.
Results:
Ninety-seven patients (M:F 35:62) aged 54 (37–64) years of age with body mass index (BMI) 26 (23–29) kg . m⁻² were enrolled in the study. Twenty-one patients (22%) were classed as severely obese (BMI > 30 kg . m⁻²). PLMA was inserted on the first attempt in 75 cases (77%), on the 2nd attempt in 14 patients (14%) and in the remaining 8 (8%) patients the insertion was successful on the 3rd attempt after a change of size of the PLMA. The PLMA cuff pressure was 40 (35–40) cm H₂O at the beginning of surgery; the capnoperitoneum pressure reached 13 (12–14) mm Hg. Peak airway pressure at the beginning of surgery (Pstart) was 17 (15–21) cm H₂O and increased to 22 (19–25) cm H₂O after CO₂ insufflation (Pcapno). Patients with BMI > 30 had higher Pstart [21(16–23) vs 17(14–20) cm H₂O; p = 0.002] and Pcapno [25 (22–30) vs 22 (19–25) cm H₂O; p = 0.001]. The difference between Pstart and Pcapno was also significant (p < 0.001).
A nasogastric tube was successfully inserted on the 1st attempt in 99% of patients. In one patient a ”fold-over” position was revealed. No gastric contents were found in 40 (41%) patients at the end of surgery; in the remaining patients a residuum of 20 ml (10–30 ml) was detected. Regurgitation of gastric juices occurred in 3 patients. No signs of lung aspiration were found.
Conclusion:
PLMA is a safe method of airway protection during laparoscopic surgery.
Keywords:
laparoscopic cholecystectomy – inspiratory pressure – regurgitation – pulmonary aspiration – laryngeal mask
Sources
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Anaesthesiology, Resuscitation and Inten Intensive Care MedicineArticle was published in
Anaesthesiology and Intensive Care Medicine
2008 Issue 2
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