[Comparison of the efficacy of different types of laryngeal mask airways in patients undergoing laparoscopic gynecological surgery].

OBJECTIVE: To compare the efficacy of laryngeal mask airway Supreme, ProSeal and I-gel in patients undergoing laparoscopic gynecological surgery. METHODS: From Jan 2010 to Sep 2012 in Beijing Hospital, approved by hospital ethics committee, ninety ASA IorII patients, aged 21-64 yr, weighing 45-90 kg, undergoing laparoscopic gynecological surgery, were randomized into 3 groups (n = 30 each): LMA Supreme group (group S), LMA ProSeal group (group P)and LMA I-gel group (group I). Mallampatti test was performed before operation for each case. Anesthesia was induced with target-controlled infusion. After the patients lost consciousness, rocuronium 0.6 mg/kg was given to facilitate the LMA insertion. LMA Supreme, LMA ProSeal and LMA I-gel were inserted in S, P and I groups respectively. A gastric tube was inserted through the drain tube of the LMA. The LMA placement time, the number of attempts of LMA insertion, the number of attempts of gastric tube placement, the airway sealing pressure, the parameters of ventilation, and complications (sore throat, odynophagia, hoarseness, regurgitation of gastric contents, LMA with adhesion of blood)were recorded. The fiberoptic laryngoscopy scores were assessed after LMA placement. The anesthesia time and recovery time were also recorded. RESULTS: There was no significant difference in the anesthesia time, recovery time, fiberoptic bronchoscopy scores among the three groups (P > 0.05). Parameters of ventilation in each group were normal. The success rates of LMA and gastric tube placement were 100% in each group. The airway sealing pressure in S, P and I groups were 25 ± 5 cm H2O, 32 ± 5 cm H2O, 30 ± 6 cm H2O respectively, the airway sealing pressure was significantly higher in group P and group I, compare with group S (P < 0.05). The LMA placement time in S, P and I groups were 8 ± 4s, 10 ± 5s, 8 ± 3s respectively, while the incidence of sore throat were 17%, 20%, 3%. The LMA placement time was significantly shorter and the incidence of sore throat was significantly lower in group I than in group P (P < 0.05). CONCLUSIONS: The three LMA can all be used effectively for gynecological laparoscopic surgery. LMA I-gel and LMA ProSeal can provide higher airway sealing pressure. LMA I-gel provides adequate ventilation during operation with fewer complications.