Application of the streamlined liner of the pharynx airway and the proseal laryngeal mask airway in elderly patients undergoing laparoscopic cholecystectomy

Abstract

Objective To compare the efficacy of the streamlined liner of the pharynx airway (SLIPA) and the proseal laryngeal mask airway (PLMA) in airway management in elderly patients undergoing laparoscopic cholecystectomy. Methods One hundred and twenty patients aged 60-75 years with American Society of Anesthesiologists (ASA) grade Ⅰ or Ⅱ undergoing laparoscopic cholecystectomy were randomly divided into three groups: the endotracheal intubation group (Group T, n=40), the SLIPA group (Group S, n=40) and the PLMA group (Group P, n=40). Endotracheal intubation and laryngeal mask airway insertion were conducted after induction of anesthesia. All the patients were ventilated with intermittent positive pressure ventilation. Mean arterial pressure and heart rate were recorded at before induction (T0), successful insertion (T1), ten minutes after pneumoperitoneum (T2), successful extubation (T3), and ten minutes after extubation (T4). The rate of successful placement at first attempt, time taken for placement, airway sealing pressure, and side effects were recorded. The incidences of post-extubation cough, backflow, aspiration, larynogospasm, bleeding, gastric distension and sore throat within 2 days after intubation were also recorded. Results The successful rates of insertion were 92.5%, 92.5%, 95.0%, respectively, at first attempt and 100.0% at second attempt in the three groups (χ2=0.268, P 0.05). There was no significant difference in post-extubation complications, including backflow, aspiration, laryngospasm and gastric distension (t=0.321, P>0.05), among the three groups, but incidences of post-extubation cough and pharyngalgia were higher in Group T than in Group S and Group P (χ2=26.674, 10.568, P<0.05). Conclusions SLIPA and PLMA can both provide adequate ventilation during operation, with few complications. SLIPA placement is the easiest, while PLMA has good airway sealing and thus is more suitable for elderly patients undergoing laparoscopic cholecystectomy. Key words: Laryngeal masks; Respiration, artificial; Cholecystectomy, laparoscopy