Korean J Anesthesiol.  2002 Jan;42(1):43-49. 10.4097/kjae.2002.42.1.43.

Efficacy and Safety of Positive Pressure Ventilation through Laryngeal Mask Airway during Laparoscopic Cholecystectomy

• Chung CJ
• Kim DY
• Park HS
• Kim HH
• Chin YJ

• KMID: 2091664
• DOI: http://doi.org/10.4097/kjae.2002.42.1.43

Abstract

BACKGROUND: We evaluated the efficacy and safety of positive pressure ventilation (PPV) with a laryngeal mask airway (LMA), compared with an endotracheal tube (ETT) during a laparoscopic cholecystectomy.
METHODS
Sixty six, ASA I II adults scheduled for an elective laparoscopic cholecystectomy were randomly assigned to LMA or ETT. Anesthesia was induced with fentanyl 2ng/kg, lidocaine 0.5 mg/kg and propofol 2 mg/kg and maintained with a continuous infusion of propofol 6 - 12 mg/kg/h in 67% N2O, atracurium and fentanyl. An ETT or LMA was placed with atracurium 0.5 mg/kg. Respiratory and hemodynamic parameters were measured before and after intraabdominal CO2 insufflation. The surgeon assessed the degree of change in gastric distension under laparoscope.
RESULTS
Oxygen saturation, end-tidal CO2, peak inspiratory pressure, expiratory tidal volume and compliance of the respiratory system didn't differ between both groups. Blood pressure and heart rate were lower in the LMA group than in the ETT group only at 5 min after induction (P < 0.05). The maintenance dose of propofol, fentanyl and atracurium were similar in both groups. Degree of change in gastric distension were similar in both groups. The LMA resulted in less coughing after removal than did the ETT (P < 0.05).
CONCLUSIONS
PPV with LMA permits adequate pulmonary ventilation and hemodynamic stability during laparoscopic cholecystectomy. Gastric distension occurs with similar frequency in LMA or ETT.

Keyword

Laparoscopic cholecystectomy; laryngeal mask airway

MeSH Terms

Adult
Anesthesia
Atracurium
Blood Pressure
Cholecystectomy, Laparoscopic*
Compliance
Cough
Fentanyl
Heart Rate
Hemodynamics
Humans
Insufflation
Laparoscopes
Laryngeal Masks*
Lidocaine
Oxygen
Positive-Pressure Respiration*
Propofol
Pulmonary Ventilation
Respiratory System
Tidal Volume
Atracurium
Fentanyl
Lidocaine
Oxygen
Propofol