Second generation laryngeal mask airway during laparoscopic living liver donor hepatectomy: a randomized controlled trial

Abstract

The second-generation laryngeal mask airway (LMA) provides a higher sealing pressure than classical LMA and can insert the gastric drainage tube. We investigated the difference in respiratory variables according to the use of second-generation LMA and endotracheal tube (ETT) in laparoscopic living liver donor hepatectomy (LLDH). In this single-blind randomized controlled trial, intraoperative arterial carbon dioxide partial pressure at 2 h after the airway devices insertion (PaCO2_2h) was compared as a primary outcome. Participants were randomly assigned to the following groups: Group LMA (n = 45, used Protector LMA), or Group ETT (n = 43, used cuffed ETT). Intraoperative hemodynamic and respiratory variables including mean blood pressure (MBP), heart rate (HR), and peak inspiratory pressure (PIP) were compared. Postoperative sore throat, hoarseness, postoperative nausea and vomiting (PONV), and pulmonary aspiration were recorded. The PaCO2_2h were equally effective between two groups (mean difference: 0.99 mmHg, P = 0.003; 90% confidence limits: − 0.22, 2.19). The intraoperative change in MBP, HR, and PIP were differed over time between two groups (P < 0.001, P = 0.015, and P = 0.039, respectively). There were no differences of the incidence of postoperative complications at 24 h following LLDH (sore throat and hoarseness: P > 0.99, PONV: P > 0.99, and P = 0.65, respectively). No case showed pulmonary aspiration in both groups. Compared with endotracheal tube, second-generation LMA is equally efficient during LLDH. The second-generation LMA can be considered as the effective airway devices for securing airway in patients undergoing prolonged laparoscopic surgery. Trial Registration This study was registered at the Clinical Trial Registry of Korea (https://cris.nih.go.kr. CRiS No. KCT0003711).

Comparison of two different flexible laryngeal airway masks in pediatric ophthalmic surgeries: A retrospective study

“…After insertion, the ventilation tube can easily conform to the anatomic radian of the oropharynx and does not cause the ventilation tube to disintegrate, which is more conducive to maintaining good airway sealing pressure. [14–18]…”

“…All the children fasted for 6 hours before the operation and were forbidden from drinking clear water for 2 hours. Peripheral venous access was established before entering the operating room and SpO 2 , ECG, and NIBP were monitored after entering Wang • Medicine (2023) 102: 15 Medicine operating room. The child was placed in a supine position with a cotton roll under the shoulder to tilt the back of the head slightly.…”

Efficacy of Laryngeal Mask Airway Compared to Endotracheal Tube: A Randomized Clinical Trial

“…Brain in 1981 and has been commercially used since 1988 (3)(4)(5). The advantages of LMA compared to tracheal intubation are no tracheal injury during tube installation and removal, less airway stimulation, less invasion of the airway tissue, easier installation, and efficient establishment (6)(7)(8)(9). Therefore, in adults, it is recommended to use LMA as a substitute for tracheal intubation, especially in patients with a history of intubation, the possibility of difficult intubation diagnosed by an anesthesiologist, and patients whose intubation has failed and venti-lation can be performed with a mask (10)(11)(12).…”

Comparison of the third-generation streamlined liner of the pharynx airway (SLIPA-3G) with the laryngeal mask airway supreme for laparoscopic cholecystectomy: a randomized prospective study

“…There were initial concerns over the risk of aspiration associated with the use of SADs during laparoscopic surgeries, as the rise in intra-abdominal pressure may cause difficulties with ventilation and an increased risk of gastric regurgitation [ 2 ]. Numerous studies have demonstrated that second-generation SADs with esophageal drainage tubes can be safely used in patients undergoing elective laparoscopic surgeries without an elevated risk of aspiration [ 3 – 7 ].…”