Can Supreme™ laryngeal mask airway be an alternative to endotracheal intubation in laparoscopic surgery?

Braz J Anesthesiol. 2014 Jan-Feb;64(1):66-70. doi: 10.1016/j.bjane.2012.12.008. Epub 2013 Dec 3.

Abstract

Background and objectives: In laparoscopic surgical procedures, experts recommend tracheal intubation for airway management. Laryngeal mask airway (LMA) can be a good alternative to intubation. In this case series, we aimed to examine the use of the Supreme™ LMA (SLMA) in laparoscopic surgical practice.

Methods: We planned the study for sixty patients between the ages of 18 and 60, who would undergo laparoscopic surgery. We recorded one, 15, 30, 45, and 60-minute peripheral O2 saturation (SpO2) and end-tidal carbon dioxide (EtCO2) values, heart rate and mean arterial blood pressure (MAP). We observed the duration of SLMA insertion, the rate of gastric tube applicability, whether nausea, vomiting, and coughing developed, and whether there was postoperative 1-hour sore throat.

Results: The initial EtCO2 mean was lower than the EtCO2 means of 15, 30, 45, and 60 minutes (p < 0.0001) and the 15-minute EtCO2 mean was lower than other measured EtCO2 means. We observed the initial heart rate mean to be higher than the ones following the SLMA insertion, prior to the SLMA removal, and after the SLMA removal. The heart rate mean after the SLMA insertion was remarkably lower than the heart rate mean prior to the SLMA removal (p=0.013). The MAP after the SLMA insertion was lower than the initial MAP means, as well as the MAP averages prior to after the removal of SLMA (p=0.0001).

Conclusion: SLMA can be a suitable alternative to intubation in laparoscopic surgical procedures in a group of selected patients.

Keywords: Intratracheal; Intubation; Laparoscopy; Laryngeal Masks.

MeSH terms

  • Adolescent
  • Adult
  • Arterial Pressure
  • Carbon Dioxide / metabolism
  • Female
  • Heart Rate
  • Humans
  • Intubation, Intratracheal / methods*
  • Laparoscopy
  • Laryngeal Masks*
  • Male

Substances

  • Carbon Dioxide