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Airway Management

LTS II versus ProSeal in laparoscopy: 19AP2-6

Georgiev, S.; Mladenov, B.

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European Journal of Anaesthesiology: June 2012 - Volume 29 - Issue - p 230-231
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Background and Goal of Study: Laryngeal Mask Airway-ProSeal (LMA-ProSeal) Symbol Laryngeal Tube Suction-II (LTS-II) are supraglottic devices which allow drainage of the stomach contents. In this prospective study we compare the conditions of securing a patent airway during laproscopy.

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Materials and Methods: We randomised 64 ASA I female patients, scheduled for laparoscopic gynaecological surgery. The two devices were placed after induction of anesthesia with Propofol. Correct positioning was verified by a leak test. The ease of placement, adequacy of ventilation and ease of placement of a gastric drainage tube (and the number of attempts) were noted on a 3 point scale. Also the time from beginning to first tidal volume was taken down.

Results and Discussion: The two groups had no statistically significant differences in the demographic data and surgery details. Both devices were placed successfully from the first attempt in all women. The time to first tidal volume with ProSeal was 20.4+/- 2.8 and with LTS II 19.2 +/- 3.6 sec. We found no clinical data for stomach distention, significant air leakage or regurgitation in any one of the women. Stomach drainage tube placement was successful in 93.3% (28 patients) with ProSeal and 100% with LTS II All patients filled a questionnaire concerning complaints of disphagia, throat irritation and voice change following surgery at 0h., 3h and 24 h. Complaints with LTS II were more severe and more frequent (4 pts vs.1 pt. for ProSeal ) Two cases of tongue oedema and cyanosis were noted in the LTS group.

Conclusion(s): As a whole both devices proved adequate and easy to handle in possible difficult intubation/ventilation situations and were able to secure the airway in a satisfactory manner. Both proved to be safe in laparoscopy. LTS II produced more dysphagia and throat discomfort, which does not however diminish its qualities as an emergency tool for airway management.

© 2012 European Society of Anaesthesiology