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Airway Management

Airway morbidity after use of the laryngeal mask airway: LMA ProSeal® vs. i-gel®


Soliveres, J.; Balaguer, J.; Richart, M. T.; Sánchez, J.; Solaz, C.

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European Journal of Anaesthesiology (EJA): June 12th, 2010 - Volume 27 - Issue 47 - p 257-258
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Background and Goal of Study: Postoperative airway morbidity with the classic laryngeal mask (LMA) and the ProSeal (LMAP) is low. The emergence of new supraglottic devices made of other materials and without cuff could lead to a reduction of undesirable events on the airway. The incidence of postoperative sore throat with the I-Gel (LMIG) laryngeal mask has not been well studied. The aim of this study is to compare the incidence of sore throat, dysphagia and hoarseness after placement of the LMAP or LMIG during general anaesthesia.

Materials and Methods: After local ethics committee approval, written informed consent was obtained from 60 ASA I-III consecutive patients scheduled for surgery in supine position with an estimated duration of general anesthesia from 45–150 min. Exclusion criteria were the use of pneumoperitoneumpneumothorax or difficult airway suspectec. Patients were randomly allocated to or of the two devices. No patient was premedicated. After induction, insertion of the LMA was performed by an expert anesthesiologist. A hydrophilic lubricant without local anesthetic was used for lubrication of de LMA. The cuff of the LMAP was sealed following the manufacturer's instructions. Proper LMA insertion was verified by a leak test at 30 cm H2O, repositioning the mask to obtain a negative leak test. Anaesthesia mainteinance was free excep for the use of nitrous oxide (not allowed). One hour and 24 hours after surgery, every patient was asked for sore throat, dysphagia or hoarseness. Chi square test and Student's t test for independent data were used as appropiate. A p<0,05 was considered significant.

Results and Discussion: Demograhic data are shown in table 1. Patients and anesthetic time were similar in both groups. Two patients in the LMAP group were excluded (failure to placement of the device and more than three attempts required) and one patient in Group IGEL (excessive length of procedure). Results are shown in table 2. No patien presented sore throat, dysphagia or hoarseness at 24 hours.

Table 1
Table 1:
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Table 2
Table 2:
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Conclusion(s): The use of LMAP produces more sore throat and dysphagia that the LMAIG. We recommend the use of the I-gel mask.

© 2010 European Society of Anaesthesiology