A Prospective Randomized Comparative Study between Baska Mask, Proseal LMA and I Gel during Positive Pressure Ventilation in Laparoscopic Cholecystectomy

Abstract

Objective: Supraglottic airway devices with facility for gastric suction such as Proseal LMA and I gel have been successfully used for positive pressure ventilation in laparoscopic surgeries. Baska mask, a novel device with many unique features such as self-sealing membranous cuff and effective sump drainage system was designed in such a way that the perilaryngeal seal increases incrementally with increasing airway pressures. But Baska mask was not extensively evaluated to validate its use in laparoscopic surgeries. The efficiency of Baska mask (B), Proseal LMA (P) and I Gel (I) are compared during positive pressure ventilation in laparoscopic cholecystectomy. Methods: Ninety patients of ASA physical status I-II planned for laparoscopic cholecystectomy were randomized into three groups (B, I, P) of 30 each. The study was proceeded with 88 (B-30, I-29, P-29) patients. Oropharyngeal leak pressure, insertion time, effective airway time and airway morbidity were assessed and compared between the three groups. Mean, standard deviation, paired sample t-test, one way ANOVA with Tukey's Post-Hoc test was used. Results: The oropharyngeal leak pressure at insertion time was 38.33±4.353 cm of H 2 O for group B, 30.57±2.174 cm of H 2 O for group I, 29.36±2.706 cm of H2O for group P. The leak pressure was statistically significant between group B and other groups. Conclusions: Baska mask provided higher oropharyngeal leak pressure in comparison to other two supraglottic devices. ÖZ Amaç: Proseal LMA ve I gel gibi gastrik aspirasyon avantajı olan supraglottik hava yolu araçları, laparoskopik ameliyatlarda pozitif basınçlı ventilasyonda başarıyla kullanılmaktadır. Kendiliğinden yerleşen membranöz cuff ve etkin sıvı drenaj sistemi gibi pek çok benzersiz özelliğe sahip yeni bir cihaz olan Baska mask, perilarengeal yerleşme basıncının, artan hava yolu basınçları ile aşamalı olarak artacağı şekilde tasarlanmıştır. Ancak, Baska maskın, laparoskopik ameliyatlarda kullanımı kapsamlı olarak araştırılmamıştır. Laparoskopik kolesistektomide pozitif basınçlı ventilasyon sırasında Baska mask (B), Proseal LMA (P) ve I Gel (I)'in etkinliği karşılaştırıldı. Yöntem: Laparoskopik kolesistektomi planlanan ASA I-II 90 hasta, üç gruba (B, I, P) randomize edildi. Çalışma 88 (B-30, I-29, P-29) hasta ile sürdürüldü. Orofarengeal kaçak basıncı, yerleştirme zamanı, etkin hava yolu zamanı ve hava yolu morbiditesi değerlendirildi ve üç grup karşılaştırıldı. İstatistiksel analizde; ortalama, standart sapma, paired sample t-testi, Tukey Post-Hoc testi ile tek yönlü ANOVA kullanıldı. Bulgular: Yerleştirme sırasında orofarengeal kaçak basıncı, B grubunda 38.33±4.353 cmH 2 0, I grubunda 30.57±2.174 cmH 2 0, P grubunda 29.36±2.706 cmH 2 0 idi. Kaçak basıncı, B grubu ve diğer gruplar arasında istatistiksel olarak anlamlıydı. Sonuç: Baska mask, diğer iki supraglottik araç ile karşılaştırıldığında daha yüksek orofaringeal kaçak basıncı sağladı. Bu çalışmada kullanılan üç farklı ikinci kuşak supraglottik hava yolu aracı arasında, Baska mask, yüksek orofarengeal ...

An Analysis of the Comparative Efficacy Between a Third-Generation and a Second-Generation Supraglottic Airway Device in Patients Undergoing Laparoscopic Cholecystectomy

“…It is a well-known fact that laparoscopic cholecystectomy requires higher intermittent positive pressure ventilation, including higher positive end-expiratory pressure [ 14 ]. There was no significant difference in laryngopharyngeal morbidity between the groups, which is in line with other studies [ 8 - 10 ].…”

“…This finding was corroborated in the study by Singh et al, who observed OSP of 30.25 ±8.34 cm H 2 O for the BM and 23.50 ±4.05 cm H 2 O for the LMA-P [ 7 ]. Also, our findings are similar to those by Dhanasekaran et al in 2019 and Ali et al in 2013; both of them affirmed that the BM has significantly higher OSP than the LMA-P [ 8 , 10 ].…”

“…Our results suggested that the mean time for insertion in the BM group (25.33 ±3.62 seconds) was comparatively shorter than that in the LMA-P group (28.77 ±6.6 seconds) (p=0.004), which is very similar to the findings in other studies [5][6][7][8][9][10]. The reason behind the quick and easy insertion of BM may be attributed to its manufacturing design, which includes a cuffless membrane and a tab to increase the palatopharyngeal curve to assist insertion.…”

Comparative evaluation of airway dynamics in patients undergoing laparoscopic cholecystectomy under general anaesthesia with controlled ventilation using ProSeal laryngeal mask airway, I-Gel™ and Baska mask

“…In another study, the leak pressure at insertion time was 38.33 ± 4.4 cm of H 2 O for group B, 30.57 ± 2.2 cm of H 2 O for group I, 29.36 ± 2.7 cm of H 2 O for group P (p = 0.04). [ 14 ] The leak pressure was significantly more in the group B, and comparable amongst groups P and I. The leak pressure after 30 minutes of insertion was 40.00 ± 2.4 cm of H 2 O for group B, 35.14 ± 3.2 cm of H 2 O for group I and 34.36 ± 1.3 cm of H 2 O for group P [p = 0.04].…”

Comparison of Baska Mask Versus Proseal Laryngeal Mask Airway in Elective Surgeries Under General Anaesthesia: A Randomized Clinical Trial

“…Ramaiah et al suggested a more widely accepted classification for SAD whose primary function is airway management under general anesthesia [13]. SAD were divided into categories according to the location of the device's cuff in the hypopharynx (and whether it is inflatable or anatomically preshaped), if it creates a seal, whether the effect of the seal is directed, and whether or not sealing of esophagus takes place: (i) Inflating mechanism with one or more cuffs, (ii) Preshaped devices that fit into the position, and (iii) Automatic or self-energizing devices, with the transmission of airway pressure to the inside of a flexible sealing element [14,15].…”