Korean J Anesthesiol.  2003 Jun;44(6):739-746. 10.4097/kjae.2003.44.6.739.

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

• Baik CY
• Won DH
• Chung CJ
• Hwang GB

• KMID: 2239947
• DOI: http://doi.org/10.4097/kjae.2003.44.6.739

Abstract

BACKGROUND: We evaluated the efficacy and safety of positive pressure ventilation (PPV) with a ProSeal laryngeal mask airway (PLMA), as compared with an endotracheal tube (ETT) and with a classic laryngeal mask airway (LMA) during laparoscopic cholecystectomy.
METHODS
One hundred, ASA 1, 2 adults scheduled for elective laparoscopic cholecystectomy were randomly assigned to ETT, LMA or PLMA. Anesthesia was induced with fentanyl 2 microgram/kg, lidocaine 0.5 mg/kg and propofol 2 mg/kg and maintained with a continous infusion of propofol 6-12 mg/kg/h in 67% N2O, atracurium and fentanyl. ETT, LMA or PLMA 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 gastric distension change using a laparoscope.
RESULTS
Oxygen saturation, end tidal CO2, inspiratory pressure, expiratory tidal volume and compliance of the respiratory system were similar in the three groups. Blood pressure and heart rate were lower in the PLMA and LMA groups than in the ETT group 5 min after induction (P < 0.05). Audible gas leakage occurred more so in the LMA group (48.5%) than in the PLMA group (8.8%). Because of inadequate ventilation, endotracheal intubation was changed in one case in the LMA group. The degrees of gastric distension change were similar in the three groups. The PLMA and LMA resulted in less coughing after removal than ETT (P < 0.05). A postoperative sore throat and dysphagia were similar in the three groups, but dysphonia was more frequent in the ETT group.
CONCLUSION
During laparoscopic cholecystectomy, PPV with PLMA provide more effective pulmonary ventilation than LMA and fewer side effects than ETT.

Keyword

Endotracheal tube; laparoscopic cholecystectomy; laryngeal mask airway; Proseal mask airway

MeSH Terms

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