Comparison of early postoperative recovery between laryngeal mask airway and endotracheal tube in laparoscopic cholecystectomy

Abstract

Background: Laryngeal mask airway (LMA) insertion provokes fewer stress responses than endotracheal intubation. This study aimed to evaluate the LMA Protector for assessing improvements in intraoperative hemodynamic stability and to reduce postoperative discomfort compared with endotracheal intubation in laparoscopic cholecystectomy. Methods: Fifty-six patients who underwent laparoscopic cholecystectomy while under sevoflurane-based general anesthesia were randomly allocated to airway management using LMA (LMA group) or endotracheal tube (ETT group). Heart rate, blood pressure, and peak airway pressure were recorded before and after carboperitoneum. Postoperative pain and analgesic requirements were assessed, in addition to nausea, hoarseness, dysphonia, and sore throat during the first 1 hour postoperatively and until postoperative day 1. Results: All patients underwent successful LMA or ETT placement within 2 attempts. There was no difference in highest mean (SD) peak airway pressure during carboperitoneum between the LMA and ETT groups (17.7 [2.8] mm Hg vs 19.1 [3.8] mm Hg, P = .159, respectively). The incidence of high systolic blood pressure and bradycardia was higher in the LMA group. The highest pain scores 1 hour postoperatively and on postoperative day 1 were lower in the LMA group than in the ETT group (3.9 [2.0] vs 5.4 [2.3], P = .017 and 5.6 [1.9] vs 6.7 [1.7], P = .042, respectively); requirements for analgesics were similar in the 2 groups. The incidence of nausea was lower in the LMA group than in the ETT group until postoperative day 1 (4/28 [14%] vs 12/28 [43%], P = .031, respectively). Conclusion: The LMA Protector was an effective ventilator device associated with fewer intraoperative hemodynamic stress responses and improved the quality of early recovery after laparoscopic cholecystectomy.

Outcomes of Transfemoral Transcatheter Aortic Valve Replacement Performed With General Anesthesia Using a Supraglottic Airway Versus Monitored Anesthesia Care

“…14 In noncardiac procedures, when compared with ETT, SGA use also has been shown to decrease the incidence of laryngospasm during emergence from anesthesia and reduced incidence of postoperative hoarse voice, sore throat, nausea, pain, and coughing. [15][16][17][18] Laryngeal mask airway devices also have been shown to induce smaller catecholamine and mean arterial pressure responses in patients undergoing bariatric surgery. 19 In addition, multiple recent studies have demonstrated the robust safety profile of TEE performed with an SGA rather than the traditional ETT.…”

“…GA using a supraglottic airway (GA-SGA) has emerged as a promising alternative to MAC or GA with an ETT (GA-ETT) for TF-TAVR. 14 Studies in noncardiac populations previously have demonstrated benefits of an SGA relative to an ETT in factors such as operating room time, 14 sore throat, 15 desaturation, 16 airway complications, 17 early recovery, 18 and catecholamine and hemodynamic responses. 19 The aim of the present study was to compare outcomes of TF-TAVR at a single institution using GA-SGA for airway maintenance versus MAC.…”

A prospective study on the incidence of sore throat after use of laryngeal mask airway during general anesthesia

“…In patients under general anesthesia, laryngeal mask airway (LMA) method is used as an alternative to endotracheal intubation to maintain the airway, and its use had been increased. The LMA method was designed in 1981 and is superior to ETT in terms of no tracheal damage during insertion and removal of the tube, less airway stimulation, less invasion of airway tissue, easier implantation and airway establishment [ 12 , 13 ]. Relative to endotracheal intubation, LMA has greater incidence of sore throat, however the intensity of sore throat may be mild and might not affect the choice of LMA [ 14 ].…”

LMA ® Protector™ In Patients Undergoing Laparoscopic Surgeries: A Multicenter Prospective Observational Study

“…Therefore, in this multicenter study, we further investigated the effectiveness and safety of LMA® Protector™ in laparoscopic surgeries in a large sample and intended to provide evidence for LMA to be used in laparoscopic surgery. (3,16)…”