Kannan, R (2007) Comparison of Proseal Laryngeal Mask Airway Vs Endotracheal Tube for Laparoscopic Surgery. Masters thesis, Madras Medical College, Chennai.
|
Text
201000107kannan.pdf Download (385kB) | Preview |
Abstract
AIM OF THE STUDY: The aim of the study was to evaluate the effectiveness of Proseal LMA compared to endotracheal tube during laparoscopic procedures based on the Haemodynamic Changes, Ventilatory Parameters and Gastric Distension. MATERIALS AND METHODS: STUDY DESIGN: This study was a randomized prospective comparative study. STUDY SETTING AND POPULATION: After obtaining patients written informed consent and institutional ethical committee clearance, the study was carried out in the General Surgery Operation Theatre, Government General Hospital, Chennai from July 2006 to August 2006. The study was conducted in 40 adult patients of either sex between the age group of 18 – 60 years belonging to ASA – I & II posted for elective laparoscopic surgeries (Cholecystectomy & Appendicectomy) at the Government General Hospital, Chennai. Inclusion Criteria: 1. Adults of either sex, 2. 18 – 60 years, 3. ASA physical status I & II, 4. Mallampati Class I – II. Exclusion Criteria: 1. Known difficult airway, 2. Cervical spine disease, 3. Mouth opening < 2.5cm, 4. Patients with risk of aspiration like i) H/o hiatus hernia, ii) Reflux oesophagitis. STUDY METHOD: Patients were randomized into 2 groups: 1) Group I (Group E) – ETT for airway management, 2) Group II (Group P) – PLMA for airway management. All Patients were fasted overnight. They were given aspiration prophylaxis with Inj-Ranitidine 50mg I.V. and Inj-Metaclopramide 10mg I.V. 1 hr before surgery 37, 38. Patients premedicated with Inj-Glycopyrrolate 0.2mg 1hr before surgery. After the placement of monitoring devices and preoxygenation, all the patients were induced with Inj-Propofol 2.5mg/kg I.V., Inj.- Fentanyl 2mg/kg I.V., and Inj-Vecuronium 0.1mg/kg I.V. Patients were intubated with cuffed ETT of appropriate sizes in the group ETT and appropriate sizes of the PLMA in the PLMA Group. SUMMARY: The comparative evaluation of the proseal LMA with tracheal intubation for laparoscopic surgeries showed no significant difference between the two groups based on the demographic variables. The PLMA group maintained better haemodynamic stability than ETT group throughout the procedure. The ventilatory parameters (SPO2, ETCo2, TV&RR, FIO2, Airway Pressure) showed no significant difference between 2 groups. The first time insertion success rate was 90% in PLMA group & 100% in ETT group. The first time passage of an OGT was 90% in PLMA group & 100% in ETT Group. There was no significant difference between the two groups based on gastric distension score noted by surgeon. CONCLUSION: 0n comparing Proseal LMA and endotracheal tube for laparoscopic surgeries, it was found that the haemodynamics were more stable when Proseal LMA was used. Proseal LMA was as effective as endotracheal tube during positive pressure ventilation in preventing gastric distension and aspiration when correctly placed. So Proseal LMA is an effective alternative to endotracheal tube in patients where the haemodynamic stability is much desirable during laparoscopic surgeries.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Comparison ; Proseal Laryngeal Mask Airway ; Endotracheal Tube ; Laparoscopic Surgery. |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Subramani R |
| Date Deposited: | 21 Apr 2018 07:20 |
| Last Modified: | 21 Apr 2018 07:20 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7180 |
Actions (login required)
 |
View Item |
