| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
* From the Departments of Anesthesia, and
Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Address correspondence to: 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 the laryngeal mask airways (LMA), LMA-ClassicTM (LMA-C) and LMA-ProSealTM (PLMA) with the endotracheal tube (ETT) with respect to pulmonary ventilation and gastric distension during gynecologic laparoscopy.
Methods: We stratified 209 women, aged 
18 yr, ASA physical status I–III, by body mass index as non-obese (# 30 kg•m-2) or obese (> 30 kg•m-2) and randomized them to LMA-C/PLMA or ETT groups for airway management. Anesthesia was induced with propofol, fentanyl and succinylcholine or rocuronium. In the LMA-C/PLMA group we used a size 4 LMA-C in non-obese patients and size 4 or 5 PLMA in obese patients. In the ETT group we used a cuffed 7.0 mm ETT in all patients. Anesthesia was maintained with isoflurane in nitrous oxide and 30–50% oxygen, fentanyl and neuromuscular blockade with mechanical ventilation (tidal volume 10 mL•kg-1). The staff surgeon, blinded to the type of airway, scored stomach size on an ordinal scale 0–10 at initial insertion of the laparoscope and immediately before the conclusion of the surgical procedure.
Results: There were no crossovers and no statistically significant differences between LMA-C/PLMA and ETT groups for SpO2, PETCO2 or airway pressure before or during peritoneal insufflation in short (# 15 min) or long (> 15 min) periods of peritoneal inflation. Differences between groups with respect to stomach size changes during surgery were not statistically significant.
Conclusion: A correctly placed LMA-C or PLMA is as effective as an ETT for positive pressure ventilation without clinically important gastric distension in non-obese and obese patients.
This article has been cited by other articles:
 |
|
 |
|
  B. Richez, L. Saltel, F. Banchereau, R. Torrielli, and A. M. Cros A New Single Use Supraglottic Airway Device with a Noninflatable Cuff and an Esophageal Vent: An Observational Study of the i-Gel Anesth. Analg., April 1, 2008; 106(4): 1137 - 1139. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. M. Galvin Is the Cobra Perilaryngeal Airway (CobraPLATM) Appropriate for Use in Patients Undergoing Gynecological Laparoscopy? Anesth. Analg., August 1, 2007; 105(2): 546 - 547. [Full Text] [PDF]
|
|
|
|
 |
|
 Part 4: Advanced Life Support Circulation, November 29, 2005; 112(22_suppl): III-25 - III-54. [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]
|
|
|
|
|
|
O. Hung and M. Murphy Changing practice in airway management: are we there yet?/Evolution dans le controle des voies aeriennes : y sommes-nous deja ? Can J Anesth, December 1, 2004; 51(10): 963 - 968. [Full Text] [PDF]
|
|
|
|
|
|
R. M. Cooper The LMA, laparoscopic surgery and the obese patient - can vs should: Le ML, la chirurgie laparoscopique et le patient obese - pouvoir vs devoir Can J Anesth, January 1, 2003; 50(1): 5 - 10. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
