Comparison of i-gel(R) and LMA Supreme(R) during laparoscopic cholecystectomy / 대한마취과학회지

BACKGROUND: In laparoscopic surgical procedures, many clinicians recommend supraglottic airway devices as good alternatives to intubation. We compared the i-gel(R) (i-gel) and LMA Supreme(R) (Supreme Laryngeal Mask Airway, SLMA) airway devices during laparoscopic cholecystectomy regarding sealing pressure and respiratory parameters before, during, and after pneumoperitoneum. METHODS: Following Institutional Review Board approval and written informed consent, 93 patients were randomly allocated into the i-gel (n = 47) or SLMA group (n = 46). Insertion time, number of insertion attempts, and fiberoptic view of glottis were recorded. Oropharyngeal leak pressure (OLP), the use of airway manipulation, peak inspiratory pressure, lung compliance, and hemodynamic parameters were measured before, during, and after pneumoperitoneum. RESULTS: There were no significant differences between the two groups regarding demographic data, insertion time, fiberoptic view of glottis, and the use of airway manipulation. The gastric tube insertion time was longer in the i-gel group (20.4 +/- 3.9 s) than in the SLMA group (16.7 +/- 1.6 s) (P < 0.001). All devices were inserted on the first attempt, excluding one case in each group. Peak inspiratory pressure, lung compliance, and OLP changed following carbon dioxide pneumoperitoneum in each group, but there were no significant differences between the groups. CONCLUSIONS: Both the i-gel and SLMA airway devices can be comparably used in patients who undergo laparoscopic cholecystectomy, and they offer similar performance including OLP.

The effects between Supreme laryngeal mask airway and endotracheal intubation on stress reaction of eld-erly hypertensive patients treated with knee arthroplasty / 临床麻醉学杂志

Objective To investigate the effects of supreme laryngeal mask airway (SLMA) and endotracheal intubation on the elderly hypertensive patients treated with knee arthroplasty. Methods Forty cases of elderly hypertensive patients ASA Ⅰ-Ⅲ treated with knee arthroplasty in our hospital were selected and randomly divided into laryngeal mask airway group (group LMA)and endotracheal intubation (group TT),20 cases for each group.The same protocol for induction and maintenance of general anesthesia was used.After the patients entering,the changes of SpO2 and ECG were performed continuous noninvasive monitoring and SBP,DBP and HR were performed con-tinuous invasive monitoring.SBP,DBP and HR of two groups were recorded at different time points:before anesthesia induction (T0 ,based value),at intubation immediate (T1 ),5 mins after intubation (T2 )and 1 5 mins after intubation (T3 ).At the same time,the content of cortisol (Cor),atrial natri-uretic peptide (ANP)and the concentration of epinephrine (E)and norepinephrine (NE)were meas-ured at the corresponding time points above.Results Compared with T0 ,SBP and DBP at T1-T3 in group LMA were decreased(P <0.05 or P <0.01);SBP and DBP at T1 in group TT were increased while decreased at T2 ,T3 ,HR at T1 were increased(P < 0.05 or P < 0.01 ).Compared with group LMA,SBP and DBP at T1-T3 and HR at T1 ,T2 in group TT were increased (P <0.05 or P <0.01). Compared with T0 and group LMA,the content of E,NE and Cor at T1-T3 increased(P <0.05 or P <0.01).The level of ANP in both groups at T1-T3 were higher than those at T0 ,and group TT were higher than group LMA(P <0.01).Conclusion Compared to endotracheal intubation,SLAM can ef-fectively reduce the stress reaction of elderly hypertensive patients treated with general anesthesia in knee arthroplasty.

Application of Supreme laryngeal mask airway to the anesthesia of poster laparoscopic surgery with lateral position / 中国医师进修杂志

Objective To study the application of Supreme laryngeal mask airway (SLMA) with new type to the general anesthesia of lateral position. Methods Sixty patients with ASA Ⅰ - Ⅱ who planned to receive selective poster laparoscopic surgery were divided into SLMA group and general tracheal tuber (GTT) group with 30 cases of each by random digits table. After fast intravenous induction SLMA and GTT were intubated respectively to obtain artificial airway in each group. The time of intubation, efficiency of success,heart rate(HR), invasive blood pressure(IVBP),airway pressure,side effects were observed and recorded. Results The intubation time in SLMA group [(15.1 ±4.0) s] was shorter than that in GTT group [(30.5 ±: 16.2) s] (t' =-5.05,P ＜0.05); there was no significant difference in efficiency of success between two groups [96.7%(29/30) vs. 76.7%(23/30),P＞ 0.05]. There was no significant difference in HR and IVBP during the time of intubation and extubation in SLMA group(P＞ 0.05), but not in GTT group(P＜0.05). There was no significant difference in the change of the airway pressure between two groups during the ventilation. There were no complications in two groups. Conclusions The time of SLMA intubation in the general anesthesia with lateral position is short. The effect of intubation and extubation to HR and blood pressure is light. The SLMA intubation is another way to set up safely artificial airway.