A Comparison of the Laryngeal Tube, Laryngeal Mask Airway ClassicTM and Laryngeal Mask Airway ProsealTM during General Anesthesia / 대한마취과학회지

ABSTRACT

BACKGROUND: The laryngeal tube is a variant of the esophageal obturator airway. We compared laryngeal tube (LT), laryngeal mask airway classicTM (LMA) and laryngeal mask airway ProsealTM (PLMA) as a airway management device during general anesthesia. METHODS: Forty-five fasted healthy adult patients were enrolled in this study into one of three groups in a randomized, single-blinded protocol. Group 1 was to receive LT for airway management, LMA for Group 2, and PLMA for Group 3. General anesthesia was induced identically in three groups with thiopental sodium 5 mg/kg followed rocuronium 0.6 mg/kg. 90 seconds later, LT, LMA or PLMA was placed for airway management. Blood pressure and heart rate were measured immediately pre-induction control value, post-insertion of device 0 min, 1 min, 3 min and 5 min. We also compared times of insertion, the amounts of secretion, blood stain, and postoperative sore throat. RESULTS: There was no significant change of SBP, DBP and HR within three groups. All the groups showed stable hemodynamic results. The success rate on the first attempt was 93.6% (14/15, Group 1), 93.6% (14/15, Group 2) and 86.6% (13/15, Group 3). Minimum cuff volume to prevent gas leakage was 69.9+/-0.5 ml (Group 1), 11.1+/-4.3 ml (Group 2) and 11.9+/-3.2 ml (Group 3). The corresponding cuff pressure was 61.6+/-22.0 cmH2O (Group 1), 4.8+/-0.9 cmH2O (Group 2) and 4.6+/-1.5 cmH2O (Group 3). Moderate, severe sore throat was 20% (3/15, Group 1), 6.6% (1/15, Group 2) and 6.6% (1/15, Group 3). Moderate, profuse secretion was 40% (6/15, Group 1), 20% (3/15, Group 2) and 13.3% (2/15, Group 3). There was a 20% (3/15, Group 1) and 13.3% (2/15, Group 3) blood stain. But there was no blood stain for the Group 2. There was a 20% (3/15) gas leakage in Group 1, so we had to insert gas intermittently, but there were no gastric distension, regurgitation, aspiration, hypoxia, airway obstruction and laryngospasm in all three groups. CONCLUSIONS: All the groups revealed stable hemodynamics, no serious complications such as regurgitation, aspiration, hypoxia and airway obstruction during general anesthesia. But we did not find any evidence that LMA and PLMA have the remarkable advantages than laryngeal tube. So we suggested that laryngeal tube could be an alternative airway management device, even though further study will be needed.