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Korean Journal of Anesthesiology 2003;44(3):304-309.
DOI: https://doi.org/10.4097/kjae.2003.44.3.304   
Airway Sealing Effect and Gastroesophageal Regurgitation of Laryngeal Mask Airway-Proseal in Laparoscopy.
Duck Hwan Choi, Hyun Sung Cho, Ik Soo Chung, Mi Kyung Yang, Tae Soo Hahm, Hyon Min Baek
Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Samsung Seoul Hospital, Seoul, Korea. tshahm@smc.samsung.co.kr
Abstract
BACKGROUND
The laryngeal mask airway Proseal (LMA-Proseal) is a renewed airway device with a modified cuff to improve the mask seal around the larynx. The classic LMA is known to have an incomplete mask seal during high positive pressure ventilation. Therefore, we examined whether the ventilation via a LMA-Proseal during laparoscopic surgery may be adequate and also observed the complications associated with a LMA-Proseal.
METHODS
Thirty four patients undergoing elective gynecological laparoscopies were studied. After the insertion of a LMA-Proseal, we measured the peak airway pressure, plateau airway pressure, oropharyngeal leakage pressure, and the leakage around the neck before and after intra-abdominal CO2 insufflation. After extubation, we observed the complications, including the gastroesophageal regurgitation using a methylene blue staining method.
RESULTS
The peak and plateau airway pressures after pneumoperitoneum increased significantly (P<0.05), compared with those before insufflation. However, the oropharyngeal leakage pressure was not changed and leakages around the neck were not observed. After extubation, a cuff stained with methylene blue occurred in 10 of 34 patients. Sore throat and dysphagia occurred in 8 and 4 of 34 patients, respectively.
CONCLUSIONS
A LMA-Proseal during laparoscopic surgery permits adequate airway pressure, but does not protect the gastroesophageal regurgitation.
Key Words: Gynecological laparoscopic surgery; laryngeal mask airway-proseal; regurgitation


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