This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Maltby, J. R. Articles by Fick, G. H. Search for Related Content PubMed PubMed Citation Articles by Maltby, J. R. Articles by Fick, G. H.

The LMA-ProSeal^TM is an effective alternative to tracheal intubation for laparoscopic cholecystectomy

[Le LMA-ProSeal^TM remplace efficacement l’intubation endotrachéale pendant la cholécystectomie laparoscopique]

J. Roger Maltby, MB BCHIR FRCA FRCPC^*, Michael T. Beriault, MD FRCPC^*, Neil C. Watson, MB FRCPC^*, David Liepert, MD FRCPC^* and Gordon H. Fick, BSc MSC PhD

^* From the Departments of Anesthesia and
Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

Dr. J. Roger Maltby, Department of Anesthesia, Foothills Medical Centre, 1403 - 29th Street NW, Calgary, Alberta T2N 2T9, Canada. Phone: 403-944-1667; Fax: 403-944-2425; E-mail: maltby{at}ucalgary.ca

Purpose: To compare LMA-ProSeal^TM (LMA-PS) with endotracheal tube (ETT) with respect to pulmonary ventilation and gastric distension during laparoscopic cholecystectomy.

Methods: We randomized 109 ASA I–III adults to LMA-PS or ETT after stratifying them as non-obese or obese (body mass index > 30 kg·m^-2). After preoxygenation, anesthesia was induced with propofol, fentanyl and rocuronium. An LMA-PS (women #4, men #5) or ETT (women 7 mm, men 8 mm) was inserted and the cuff inflated. A #14 gastric tube was passed into the stomach in every patient and connected to continuous suction. Anesthesia was maintained with nitrous oxide, oxygen and isoflurane. Ventilation was set at 10 mL·kg^-1 and 10 breaths·min^-1. The surgeon, blinded to the airway device, scored stomach size on an ordinal scale of 0–10 at insertion of the laparoscope and upon decompression of the pneumoperitoneum.

Results: There were no statistically significant differences in SpO₂ or P_ETCO₂ between the two groups before or during peritoneal insufflation in either non-obese or obese patients. Median (range) airway pressure at which oropharyngeal leak occurred during a leak test with LMA-PS was 34 (18–45) cm water. Change in gastric distension during surgery was similar in both groups. Four of 16 obese LMA-PS patients crossed over to ETT because of respiratory obstruction or airway leak.

Conclusions: A correctly seated LMA-PS or ETT provided equally effective pulmonary ventilation without clinically significant gastric distension in all non-obese patients. Further studies are required to determine the acceptability of the LMA-PS for laparoscopic cholecystectomy in obese patients.

This article has been cited by other articles:

				U. Freo, M. Carron, M. Micaglio, and C. Ori ProSeal laryngeal mask airway for laparoscopic gastric banding in a myasthenic, morbidly obese patient Br. J. Anaesth., December 1, 2007; 99(6): 921 - 922. [Full Text] [PDF]

				K. Goldmann, J. Dieterich, and M. Roessler Laryngopharyngeal mucosal injury after prolonged use of the ProSealTM LMA in a porcine model: a pilot study: [Lesion de la muqueuse laryngo-pharyngee suite a une utilisation prolongee du masque larynge ProSealTM dans un modele porcin: une etude pilote] Can J Anesth, October 1, 2007; 54(10): 822 - 828. [Abstract] [Full Text] [PDF]

				D. M. Miller and L. Camporota Advantages of ProSealTM and SLIPATM airways over tracheal tubes for gynecological laparoscopies: [Les avantages des canules ProSealTM et SLIPATM sur les tubes endotracheaux pour les laparoscopies gynecologiques] Can J Anesth, February 1, 2006; 53(2): 188 - 193. [Abstract] [Full Text] [PDF]

				T. M. Cook, G. Lee, and J. P. Nolan The ProSealTM laryngeal mask airway: a review of the literature: [Le masque larynge ProSealTM : un examen des publications] Can J Anesth, August 1, 2005; 52(7): 739 - 760. [Abstract] [Full Text] [PDF]

				H. Shimbori, K. Ono, T. Miwa, N. Morimura, M. Noguchi, and K. Hiroki Comparison of the LMA-ProSealTM and LMA-ClassicTM in children Br. J. Anaesth., October 1, 2004; 93(4): 528 - 531. [Abstract] [Full Text] [PDF]

				T. M. Hemmerling, P. Beaulieu, K. E. Jacobi, D. Babin, and J. Schmidt Neuromuscular blockade does not change the incidence or severity of pharyngolaryngeal discomfort after LMA anesthesia: [Le blocage neuromusculaire ne modifie pas l'incidence ou la severite de l'inconfort pharyngo-larynge apres l'anesthesie avec un ML] Can J Anesth, August 1, 2004; 51(7): 728 - 732. [Abstract] [Full Text] [PDF]

				W. H. Rosenblatt The Use of the LMA-ProSealTM in Airway Resuscitation Anesth. Analg., December 1, 2003; 97(6): 1773 - 1775. [Abstract] [Full Text] [PDF]

				J. R. Maltby, M. T. Beriault, N. C. Watson, D. J. Liepert, and G. H. Fick LMA-ClassicTM and LMA-ProSealTM are effective alternatives to endotracheal intubation for gynecologic laparoscopy: [Le ML ClassiqueTM et le ML ProSealTM peuvent remplacer efficacement l'intubation endotracheale pour la laparoscopie gynecologique] Can J Anesth, January 1, 2003; 50(1): 71 - 77. [Abstract] [Full Text] [PDF]