Title: Comparison of First Attempt Success Rate between Two Insertion Techniques of Proseal Laryngeal Mask Airway
Authors: Dr Madhusoodanan Pillai.C, Dr Sreeja Hariharan
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.170
Abstract
Background: The Pro Seal laryngeal mask airway (ProSeal LMA) is a relatively new laryngeal mask device designed to improve ventilator characteristics and offer protection against aspiration and gastric insufflation. But there were occasional problems like failed insertion and inadequate ventilation, in placing Pro Seal LMA using the classical digital technique. To overcome these problems, newer placement technique like introducer tool placement and Gum elastic bougie aided placement were advised.
Aim: To compare the first attempt success rate between bougie guided insertion versus introducer guided insertion of Pro Seal LMA.
Methodology: This prospective comparative study was conducted in the Dept. of Anesthesiology, Govt. Medical College , Thiruvananthapuram, a tertiary care centre . A total of 100 patients, requiring general anaesthesia with supraglottic airway device, of age between 20-60 years with ASA I and II were enrolled in the study. The enrolled patients were divided randomly into two groups-Group 1and Group 2.
Group 1 -ProSeal LMA insertion by bougie guided technique.
Group 2 -ProSeal LMA insertion of introducer technique.
Data were collected about ease of insertion, number of attempts and time taken to provide an effective airway, efficacy of seal, ease of gastric tube placement, haemodynamic responses and blood staining. Data also collected about postoperative airway morbidity.
Results: The first attempt success rate was high in bougie guided insertion of Pro Seal LMA (98% vs86%). The effective airway time is longer in patients with bougie guided insertion compared to introducer guided insertion
Conclusion: The bougie guided insertion of Pro Seal LMA has a higher first attempt success rate than the introducer technique.
Keywords: airway, ProSeal LMA, technique.
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