INFLATABLE V/S PRE-SHAPED CUFF OF SUPRAGLOTTIC AIRWAY DEVICES IN LAPAROSCOPIC SURGERY

Dr.Noopur Naik; Dr. Neha Shah

Volume : VIII, Issue : VII, July - 2019

INFLATABLE V/S PRE-SHAPED CUFF OF SUPRAGLOTTIC AIRWAY DEVICES IN LAPAROSCOPIC SURGERY

Dr. Noopur Naik, Dr. Neha Shah

Abstract :

BACKGROUND: LMA–Supreme and I–Gel are two novel 2nd generation supraglottic airway devices with gastric access. – AIM: We evaluated safety and efficacy of I–Gel (Pre–shaped cuff) versus LMA–Supreme (inflatable cuff) as ventilatory devices for providing adequate seal in patients undergoing gynaecological laparoscopic surgery with controlled ventilation. METHODS: A prospective randomized single blind study was conducted in 90 ASA I/II adult female patients of 20–50 years ,weighing 40–70 kg, undergoing surgery of less than 2 hours of duration under general anaesthesia. They were randomly allocated into the group S (LMA–Supreme, n=45) and group I (I–Gel, n=45). Study device was inserted as per manufacturer’s recommendation. Effective airway insertion time, ease and number of attempt of insertion, gastric tube insertion time, oropharyngeal leak pressure, respiratory and hemodynamic parameters, and complications were recorded. Statistical analysis was done using student t test. RESULTS: 97% LMA–Supreme and 91% I–Gel were successfully inserted on first attempt with effective insertion time of 17.13+/–3.15 seconds and 18.86+/–3.30 seconds respectively (p<0.05). Oropharyngeal leak pressure(OLP)and inspired–expired tidal volume difference were 27.04+/–1.29 cm of H20;15.68+/–6.61 ml in group S and 26.22+/–1.86 cm of H2O;21.48+/–8.45ml in group I, respectively(p<0.05).Gastric tube insertion time was 22.95+/–5.02 seconds in group S whereas 34.42+/–10.10 seconds in group I. Other parameters were comparable. CONCLUSION: Both LMA–Supreme and I–Gel are safe and effective ventilatory devices in patients undergoing gynaecological laparoscopic surgery in Trendelenburg position with controlled ventilation; but LMA –Supreme is easy to insert and provide better airway seal pressure than I–Gel