Comparison of the proseal, supreme, and i-gel SAD in gynecological laparoscopic surgeries.

Sanli Mukadder,Kayhan Gulay Erdogan,Yologlu Saim,Ozgul Ulku,Durmus Mahmut,Ucar Muharrem,Begec Zekine

doi:10.1155/2015/634320

Sanli Mukadder, Kayhan Gulay Erdogan + Show 5 more

Open Access

https://doi.org/10.1155/2015/634320

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Journal: TheScientificWorldJournal	Publication Date: Jan 1, 2015
Citations: 36	License type: CC BY 3.0

Affiliation: Inonu University

Abstract

We compared proseal, supreme, and i-gel supraglottic airway devices in terms of oropharyngeal leak pressures and airway morbidities in gynecological laparoscopic surgeries. One hundred and five patients undergoing elective surgery were subjected to general anesthesia after which they were randomly distributed into three groups. Although the oropharyngeal leak pressure was lower in the i-gel group initially (mean ± standard deviation; 23.9 ± 2.4, 24.9 ± 2.9, and 20.9 ± 3.5, resp.), it was higher than the proseal group and supreme group at 30 min of surgery after the trendelenburg position (25.0 ± 2.3, 25.0 ± 1.9, and 28.3 ± 2.3, resp.) and at the 60 min of surgery (24.2 ± 2.1, 24.8 ± 2.2, and 29.5 ± 1.1, resp.). The time to apply the supraglottic airway devices was shorter in the i-gel group (12.2 (1.2), 12.9 (1.0), and 6.7 (1.2), resp., P = 0.001). There was no difference between the groups in terms of their fiber optic imaging levels. pH was measured at the anterior and posterior surfaces of the pharyngeal region after the supraglottic airway devices were removed; the lowest pH values were 5 in all groups. We concluded that initial oropharyngeal leak pressures obtained by i-gel were lower than proseal and supreme, but increased oropharyngeal leak pressures over time, ease of placement, and lower airway morbidity are favorable for i-gel.

Highlights

The use of supraglottic airway devices (SAD) with a gastric emptying tube in gynecological laparoscopic surgeries is growing
Whereas the initial oropharyngeal leak pressure was lower in the i-gel compared to the proseal and supreme, it was higher at 30 min in the trendelenburg position and at the 60 min of surgery (P < 0.001; Table 2)
In our study we found that insertion time was shorter in the i-gel than proseal and supreme SAD

Summary

Introduction

The use of supraglottic airway devices (SAD) with a gastric emptying tube in gynecological laparoscopic surgeries is growing. In addition to their ease of placement, they have low airway morbidity along with sufficient airway pressure in the trendelenburg position and so they have been determined as an alternative to endotracheal tube [1, 2]. The proseal SAD (LMA Proseal, Laryngeal Mask Company Ltd., Henley-on Thames, UK) is reusable, supraglottic airway device made of silicon and has a gastric emptying tube and inflatable pharyngeal cuff [3, 4]. The supreme SAD (LMA, Laryngeal Mask Company Ltd., Henley-on Thames, UK) is a single-use inflatable airway device with an ellipsoid semihard head made of medical silicon and gastric emptying tube in addition to the ventilation tube. Supreme and i-gel, are single-use devices and advantageous [5]

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Conclusion