Ventilation with proSeal laryngeal mask airway during short-term elective gynecologic surgery

ABSTRACT

The laryngeal mask airway [LMA] is a supraglottic airway device that can be used as a substitute for the standard endotracheal tube in emergency and difficult airway managements. However, the use of LMA for elective surgical procedures is still controversial. In most published studies, ETCO2 and SPO2 monitoring was applied to assess the adequacy of LMA placement. However, the most reliable method for evaluating ventilation and oxygenation is the measurement of arterial oxygen partial pressure [PaO2] and arterial carbon dioxide partial pressure [PaCO2] directly from an arterial blood sample. The purpose of this descriptive cross-sectional study was to evaluate ventilation and oxygenation with ProSeal laryngeal mask airway [PLMA] during short-term elective gynecologic surgery in paralyzed anesthetized patients. Fifteen ASA [American Society of Anesthesiologists] class I-II women undergoing short-term elective gynecologic operations under general anesthesia were included in the study. After induction of standard general anesthesia an appropriate size ProSeal LMA was inserted and controlled ventilation was established. Position of LMA was detected via auscultation of the lungs and epigastric area. Before the end of surgery, an arterial blood sample was withdrawn for blood gas analysis. First attempted insertion of PLMA was successful in all patients. The position of PLMA was good in 11, acceptable in 2 and suspected in 2 patients. PaO2, PaCO2 and SaO2 were within the normal limits in all situations. Duration of anesthesia [> 30 min and < 30 min] had no effect on PaO2. We concluded that ventilation and oxygenation can be maintained through a PLMA during short-term elective gynecologic surgery under general anesthesia