Comparison of proseal laryngeal mask airway versus endotracheal tube in laparoscopic abdominal surgeries under general anaesthesia- a clinical study.

Abstract

Background: Traditional open surgeries are progressing to minimally invasive keyhole laparoscopic surgeries. Simultaneously, airway management of patients has also progressed from insufflations to endotracheal intubation (ETT) to lesser invasive devices like Pro Seallary ngeal mask airway (PLMA). Hence, the present study was undertaken to compare the efficacy of PLMA with the standard PVC endotracheal tube in patients posted for elective laparoscopic abdominal surgery under general anaesthesia.Method: Total 60 adult patients of ASA grade I or II, age between 18-60 years were enrolled in the study and divided into two equal groups. Group P was proseal laryngeal mask airway group and group E underwent endotracheal intubation. The ease and time for insertion, hemodynamic stress response and postoperative laryngopharyngeal morbidity was notedand compared between two groups. Results: The time required to insert the PLMA was less(16.96 seconds) than that of endotracheal tube (22.16 seconds). In group P, insertion was easy (first attempt) in 90% and in group E, 86.6% patients. Hemodynamic response was significantly lower (p<0.05) in the PLMA group upto five minutes of insertion of device. Mean time required passing the nasogastric tube in group P was 10.66 seconds and in group E was 20.23 seconds. Postoperative laryngopharyngeal morbidity was less (9.9%) with the PLMA than the endotracheal tube (53.3%). Intraoperative oxygenation and ventilation was adequate in both the groups. Conclusion: Thus, the proseal laryngeal mask airway proved to be a suitable and safe alternative to endotracheal tube for airway management in elective, fasted adult patients undergoing laparoscopic surgeries.