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2014, Number 4

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Acta Med 2014; 12 (4)

Security and effectiveness of the laryngeal mask airway Supreme compared with endotracheal tube for mechanic ventilation in laparoscopic cholecystectomy

Torres-Prado DE, Samperio-Guzmán MA, Pinto-Segura ME, Rendón-Macías ME

Language: Spanish
References: 24
Page: 173-180
PDF size: 175.81 Kb.


ABSTRACT

Objective: To determine the safety and effectiveness of the LMA Supreme (MLS) for airway management (MVA) in laparoscopic cholecystectomy. Design: Single blind randomized clinical trial. Location: Hospital Ángeles Clínica Londres. Patients: Adults with scheduled surgery, ASA I/II, clinically easy airway and BMI ‹ 30 kg/m2. Interventions: MLS against endotracheal tube (TET), 30 per group. Measurements: Ease of insertion, hemodynamic changes post-insertion, transanesthetic ventilatory control (SpO2, airway pressure, ETCO2) and post-extraction adverse events (hypoxemia, regurgitation-bronchoaspiration, laryngospasm and/or bronchospasm). Results: The frequency of faulty insertion of device at the first attempt was lower with MLS (7%, 2/30 against TET: 24%, 7/30, p = 0.06). There was a lower proportion of systolic hypertension (difference 20%, IC95% 2 to 37%, p = 0.02), diastolic hypertensión (difference 36.7%, IC95% 16 to 54% p = 0.001), and tachycardia (difference 13.3%, IC95% -2.9 to 30.5%, p = 0.09) when using MLS. All the patients maintained adequate transanesthetic ventilation. When removing the device there were no hypoxemia events, regurgitation, bronchospasm or post-surgical oropharyngeal pain. One patient (TET) had laryngospasm. Conclusions: The MLS is easier to insert without altering the patient hemodynamically after placement; it is also safe and effective for MVA in laparoscopic cholecystectomy.


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