The ProSeal™ Laryngeal Mask Airway and the Laryngeal Tube Suction™ for ventilation in gynaecological patients undergoing laparoscopic surgery

Background and objective: ProSeal(TM) Laryngeal Mask Airway (PLMA) and Laryngeal Tube Suction(TM) (LTS), supraglottic airway devices allowing gastric drainage, were compared in this prospective, randomized study for airway management under conditions with elevated intra-abdominal pressure induced by capnoperitoneum. Methods: Fifty patients undergoing elective gynaecological laparoscopic surgery were randomized to two groups of 25 each. After induction of general anaesthesia, devices were inserted, correct placement was verified, airway leak pressure was measured, and a gastric tube was inserted. Ease of insertion, quality of airway seal, risk of gastric insufflation and patient comfort were investigated. Results: There were no differences in patient characteristics data for both groups. First-time insertion success rates were comparable for both groups: 92% - first attempt, 8% - second attempt for PLMA and LTS. Time until delivery of the first tidal volume for PLMA and LTS was 23.2 +/- 6.1 and 23.5 +/- 6.6 s, airway leak pressure was 45.4 +/- 4.9 cmH(2)O and 45.6 +/- 6.7 cmH(2)O with cuff pressures adjusted to 60 cmH(2)O. No gastric insufflation, gas loss or signs of regurgitation were detected. Placement of a gastric tube was successful in all patients. Patients were questioned for sore throat and dysphagia after removal of devices. Sore throat was stated in 1961096 (PLMA) and 8%/4% (LTS) after 6/24 h, dysphagia in 4%/4% (PLMA) and 12%/4% (LTS). Conclusions: Both devices provide a secure air-way even under conditions of elevated intra-abdominal pressure. In this pilot study, no differences concerning handling or quality of airway seal were detected between PLMA and LTS.