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Advantages of ProSeal^TM and SLIPA^TM airways over tracheal tubes for gynecological laparoscopies

[Les avantages des canules ProSeal^TM et SLIPA^TM sur les tubes endotrachéaux pour les laparoscopies gynécologiques]

From the Department of Anaesthetics, Guy’s, King’s and St. Thomas’ School of Medicine, King’s College London, London, United Kingdom.

Address correspondence to: Dr. Donald M. Miller, GKT Department of Anaesthetics, 2nd Floor, NGH, Guy’s Hospital, London SE1 9RT, United Kingdom. Phone: +44 20 71880637; Fax: +44 20 71880642; E-mail: donald.miller{at}kcl.ac.uk

Purpose: To compare the efficacy of the ProSeal LMA^TM and SLIPA^TM supralaryngeal airways (SLA) with the standard tracheal tube (TT) in 150 consecutive day-case laparoscopic gynecological surgery procedures requiring general anesthesia.

Methods: One hundred and fifty patients were randomized into three groups. An identical general anesthesia technique was used in all patients apart from the addition of muscle relaxants and reversal drugs in the TT group. Patients were excluded if there were risk factors for gastroesophageal reflux. Ease of use, quality of seal, ventilation, systolic pressure, response to intubation, side effects and operating room time were assessed.

Results: Both ProSeal LMA^TM and SLIPA^TM were easy to insert (100% success) and ventilate with respective mean (standard deviation) maximum sealing pressures of 31 (4.6) and 30 (5.2) cmH₂O (P = 0.4) with no muscle relaxants. The seal quality in both ProSeal LMA^TM and SLIPA^TM permitted the use of low flows, 485 (291) and 539 (344) mL·min^–1 (P = 0.2) respectively, although in the TT group significantly lower flows [377 (124) mL·min^–1], (P < 0.01) were achieved. Systolic pressure in the SLA groups was more stable in response to insertion than in the TT. With ProSeal^TM there was a lower incidence of sore throats than with TT (30% vs 57%), (P < 0.05), but there was a lesser difference as compared with SLIPA^TM (30% vs 49%), (P > 0.05). With both SLAs, there was a significant reduction in operating room time (> three minutes), (P < 0.001).

Conclusions: These results suggest that the ProSeal LMA^TM (reusable) and SLIPA^TM (single-use) SLAs were easy to use without requiring muscle relaxants, and reduce operating room time compared to the TT technique in day case laparoscopies.

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