Comparative Study of Intracuff Pressure Changes in Laryngeal Mask Airway Proseal and Supreme in Patients Undergoing Laparoscopic Cholecystectomy

Abstract

Background: Second generation Supraglottic airway devices (SADs) made of silicone or polyvinyl chloride (PVC) have improved airway seal enabling the use of higher airway pressures during positive pressure ventilation (PPV) in surgeries requiring pneumoperitoneum.
Aims: To compare intracuff pressure changes and postoperative complications in laryngeal mask airway (LMA) Proseal and LMA Supreme in patients undergoing laparoscopic cholecystectomy.
Material and Methods: Eighty patients (18 - 60 years) of American Society of Anesthesiologists grade 1 & 2, scheduled for elective laparoscopic cholecystectomy were randomly allocated into two groups. After induction of general anaesthesia, LMA Supreme or LMA Proseal of appropriate size was then inserted randomly and their cuff was inflated with air of adequate volume to achieve an intracuff pressure of 60 cmH2O using a cuff pressure manometer. Intracuff pressure was measured at the end of LMA insertion and thereafter at 20 minutes interval. Any traces of visible gastric fluid, blood staining, trauma on the LMAs and postoperative complications were noted.
Results: Intracuff pressure increased significantly in LMA Proseal from 60 cmH2O to 81.35 ± 7.25 cmH2O as compared to LMA Supreme (60 cmH2O to 61.95 ± 2.74 cmH2O). There was more blood staining and sore throat in LMA Proseal than LMA Supreme.
Conclusion: LMA Supreme is a good alternative to LMA Proseal in laparoscopic cholecystectomy.