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Influence of lateral position and pneumoperitoneum on oropharyngeal leak pressure with two types of laryngeal mask airways
Author(s) -
Lan S.,
Zhou Y.,
Li J. T.,
Zhao Z. Z.,
Liu Y.
Publication year - 2017
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12943
Subject(s) - medicine , supine position , pneumoperitoneum , anesthesia , ventilation (architecture) , laryngeal mask airway , sore throat , leak , peak inspiratory pressure , airway , surgery , respiratory system , tidal volume , laparoscopy , mechanical engineering , environmental engineering , engineering
Background An important parameter to monitor adequate ventilation for laryngeal mask airway ( LMA ) is its oropharyngeal leak pressure ( OLP ). This study was designed to evaluate and compare the effect of lateral position and pneumoperitoneum on the OLP and ventilation efficiency between LMA ™ Proseal ( PLMA ) and LMA ™ Supreme ( SLMA ). Methods Patients were randomized to receive either the PLMA or the SMLA . The OLP was assessed in both the supine position and the lateral position with or without pneumoperitoneum. Minute ventilation was increased to maintain normal Et CO 2 as far as possible. Ventilatory efficiency was scored as Class I (optimal, Et CO 2 35–45 mmHg), Class II (suboptimal, Et CO 2 45–55 mmHg) and Class III (poor, Et CO 2 >55 mmHg). Adverse events associated with LMA such as blood staining on the mask and sore throat were also recorded. Results Within each group, the OLP was higher in the supine position than that in the lateral position with or without pneumoperitoneum ( P < 0.01). However, pneumoperitoneum did not further decrease the OLP . The OLP with PLMA was higher compared with SLMA regardless of the position and pneumoperitoneum ( P < 0.05 or 0.01). There was no significant difference in the number of patients in Class I/ II / III for ventilation scores in the lateral position with pneumoperitoneum (83/7/2 in PLMA group and 76/14/2 in SLMA group, respectively). The incidence of adverse events was comparable in both groups. Conclusion Our data demonstrate that the PLMA has a higher OLP in comparison with the SLMA in the lateral position for laparoscopic surgery. Both devices provide comparably adequate ventilatory efficiency.