An Analysis of the Comparative Efficacy Between a Third-Generation and a Second-Generation Supraglottic Airway Device in Patients Undergoing Laparoscopic Cholecystectomy.

Raksha Kundal,Nikki Sabharwal,Anil Kumar,Darvish Hussain

doi:10.7759/cureus.22592

Abstract

Background and objectiveSupraglottic airway devices are extensively used nowadays to secure the airway and minimize postoperative airway-related complications. This study aimed to evaluate whether the Baska® mask (BM) provides higher seal pressure and a better first-time insertion compared to the laryngeal mask airway (LMA) ProSeal™ (LMA-P) in adult laparoscopic cholecystectomy.MethodologyThis prospective, randomized, single-blinded interventional study was performed after obtaining ethical approval from the Institutional Ethics Committee at the Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. Sixty adult patients of both genders scheduled for laparoscopic cholecystectomy under general anesthesia were divided into two groups, with 30 patients in each group. Our study observed the number of insertion attempts, time of insertion, oropharyngeal seal pressure (OSP), number of patients requiring manipulation for proper placement of supraglottic airway devices, and ease of insertion.ResultsThere were no significant differences in terms of insertion attempts, ease of insertion, and laryngopharyngeal morbidity between the groups. The mean OSP at five minutes was 31.55 ±2.23 cm H2O, and that at 30 minutes was 35.86 ±3.70 cm H20 in the BM group, while in the LMA-P group, it was 24.17 ±3.74 cm H20 and 25.97 ±3.79 cm H20 respectively (p<0.001). In our study, the trend of OSP continued to increase in the BM group more than in the LMA-P group during surgery.ConclusionThe BM provided better OSP than the LMA-P, which was observed throughout the surgery.

Highlights

Supraglottic airway devices have been used extensively to manage various laparoscopic surgeries [1]
There were no significant differences in terms of insertion attempts, ease of insertion, and laryngopharyngeal morbidity between the groups
The trend of oropharyngeal seal pressure (OSP) continued to increase in the Baska® mask (BM) group more than in the laryngeal mask airway (LMA)-P group during surgery

Summary

Introduction

Supraglottic airway devices have been used extensively to manage various laparoscopic surgeries [1]. The recently developed Baska® mask (BM) is a singleuse device with a non-inflatable cuff made of silicone [3]. This device takes the shape of a supraglottic airway and inflates and deflates with positive pressure ventilation, thereby preventing leaks. It contains side channels for suctioning aspirates, oesophageal drains, and an integrated bite block. It has a second oropharyngeal curve that can be manipulated by pulling the tab of the BM. This study aimed to evaluate whether the Baska® mask (BM) provides higher seal pressure and a better first-time insertion compared to the laryngeal mask airway (LMA) ProSealTM (LMA-P) in adult laparoscopic cholecystectomy

Objectives

Methods

Conclusion