“A COMPARATIVE EVALUATION OF PROSEAL LMA AND ENDOTRACHEAL TUBE IN PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC SURGERY UNDER GENERAL ANAESTHESIA”

Abstract

Background and Aim: To compare the efficacy of Proseal laryngeal mask airway (PLMA) and endotracheal tube (ETT) in adult patients undergoing elective laparoscopic surgeries under general anaesthesia. Material and Methods: This prospective randomised study was conducted on 60 adult patients, 30 each in two groups, of either sex, ASA I-II and MPG I-II. After preoxygenation, anaesthesia was induced with propofol, fentanyl and succinylcholine. PLMA or ETT was inserted and cuff inflated. Nasogastric tube (NGT) was passed in all patients. Anaesthesia was maintained with O₂, isoflurane and vecuronium. Ventilation was set at 8 ml/kg and respiratory rate of 12/min. Results: Demographic and surgery related variables were comparable. The number of attempts and time taken for insertion of airway devices, ease of NGT insertion, haemodynamic changes, oxygenation, ventilation and intra-operative and post-operative laryngopharyngeal morbidity (LPM) were noted. There was no failed insertion of devices. Time taken for successful insertion of device was 20.3 s and 27.5 s for groups P and E, respectively. There were no statistically significant differences in oxygen saturation (SpO₂) or end-tidal carbon dioxide (EtCO₂) between the two groups before or during peritoneal insufflation. There was no case of inadequate ventilation, regurgitation, or aspiration recorded. No significant difference in LPM was noted except for post-operative sore throat. Conclusion: A properly positioned PLMA proved to be a suitable and safe alternative to ETT for airway management in elective fasted, adult patients undergoing laparoscopic surgeries. It provided equally effective pulmonary ventilation despite high airway pressures without gastric distension, regurgitation, and aspiration.