The Laryngeal Mask Airway Supreme for positive pressure ventilation during laparoscopic cholecystectomy

Abstract

Study Objective To evaluate the Laryngeal Mask Airway Supreme (SLMA) in patients undergoing laparoscopic cholecystectomy. Design Prospective observational study. Setting University-affiliated hospital. Patients 100 ASA physical status 1, 2, and 3 adult patients undergoing laparoscopic cholecystectomy with general anesthesia. Interventions The SLMA was inserted in all study patients. Patients were placed in the reverse Trendelenburg position. Measurements Ease of insertion of the device and the drain tube, oropharyngeal leak pressure, frequency of postoperative sore throat, and other adverse events were recorded. The surgeon scored stomach size on an ordinal scale of 0–10 at insertion of the laparoscope and before decompression of the pneumoperitoneum. Main Results Insertion of the SLMA was successful in all patients (91 pts on the first attempt, 9 pts on the second attempt). Gastric tube insertion was successful in all patients (easy in 97 pts, difficult in 3 pts). Initial mechanical ventilation was adequate in all cases. Mean oropharyngeal leak pressure at the 60 cm H 2O cuff pressure level was 28.8 cm H 2O (±5.2; range 18–40 cm H 2O). Mean airway pressure before pneumoperitoneum was 17.5 cm H 2O (±3.3; cm; range 11–26 cm H 2O) and 22.9 cm H 2O (±4 cm; range 16–32 cm H 2O) after pneumoperitoneum. Median (range) stomach size on insertion of the laparoscope and change in stomach size during surgery did not interfere with the procedure in any patient. Twelve patients (12%) complained of a mild sore throat postoperatively. No other complications were reported. Conclusions The SLMA is easy to insert and it is an effective ventilatory device for laparoscopic cholecystectomy.