Publication:

Comparative study of various supraglottic devices with clinical and fiber optic assessment in elective laparoscopic procedures

Background Aim of present study was to compare the efficacy and safety of supraglottic devices (LMA supreme, LMA proseal and I-Gel) by clinical and fiberoptic evaluation in elective laparoscopic surgeries under general anaesthesia with controlled ventilation.

Methods The design was a prospective, randomized study enrolling total 105 patients of either sex, (age 18-65 years), ASA grade I/II and mallampati score I and II, were randomly allocated to LS (LMAS), LP (PLMA), and IG (I-Gel) groups according to the supraglottic device applied. The three devices were compared as regards insertion parameters, adequacy of ventilation (oxygen saturation, endtidal carbon dioxide and air leak), fibreoptic vision and intra or postoperative complications.

Results The overall ease of insertion of LMAS was found to be better than the other two devices. Adequacy of ventilation was comparable in all the study groups. Safety of these devices was found to be comparable but if OLP was considered as a marker of safety of the device, LMA proseal was a better option than the other two devices. There was no significant difference in the fiberoptic view of the laryngeal inlet between the three study groups but the number of patients with grade 4 view of laryngeal inlet fiberoptic was more in I gel than LMA proseal and LMA supreme.

Conclusions It was concluded that the LMAS, PLMA and I-Gel are effective ventilatory devices during controlled ventilation, without major complications. But in clinical practice it is advisable to monitor peak airway pressure, OLP and laparoscopic view of gastric distension whenever these devices are used in laparoscopic surgeries.