ProSeal laryngeal mask airway: experience of first 100 cases of laparscopic surgery
Sharma, Bimla; Sahai, Chand; Bhattacharya, Abhijeet and Kumara, V.P. (2002) ProSeal laryngeal mask airway: experience of first 100 cases of laparscopic surgery. 50th National Conference of Indian Society of Anaesthesiologists Coimbatore 2002.
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Laparoscopic surgery is becoming increasingly popular these days. Tracheal intubation along with controlled ventilation is the most ideal for the management of such cases. Apart from its use in gynaecological laparoscopy Laryngeal Mask Airway (LMA) is not very popular for positive pressure ventilation for fear of gastric distension, aspiration of gastric contents and inadequate ventilation. The Proseal Laryngeal Mask Airway (PLMA) is a modified version of LMA with a larger cuff and a drain tube. Its cuff forms a more effective seal around the glottis than does the LMA and the drain tube provides a bypass channel for regurgitated gastric contents. The aim of the study was to assess the use of PLMA as a ventilatory device in anaesthetised paralysed patients for various elective laparoscopic surgical procedures. It is a descriptive study comprising of 100 patients of either sex, age 13-85 years, and belonging to ASA I-III. Patients with gastro oesophageal reflux disease, full stomach and interdental distance less than 2.5 cm were excluded from the study. We assessed insertion characteristics, haemodynamic responses to insertion, ease of gastric tube placement, gastric insufflation and postoperative sore throat. The results were statistically analysed which showed that PLMA is a reliable airway management device. It provided an effective glottic seal in all patients in our study. The device allowed easy passage of gastric tube, caused minimum haemodynamic responses to insertion and a low incidence of sore throat. There were two cases of regurgitation but no incidence aspiration in our series.
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