Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study

Lemos, Jeconias Neiva; Oliveira, Gildàsio S. De; Cardoso, Hugo Eckner Dantas de Pereira; Lemos, Lavínia Dantas Cardoso Neiva; Carvalho, Lígia Raquel de; Módolo, Norma Sueli Pinheiro

doi:10.1016/j.jclinane.2016.07.038

Cited by 11 publications

(6 citation statements)

References 19 publications

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“…However, previous studies have shown that even the use of classical LMA or ProSeal LMA did not increase the risk of passive regurgitation or gastric aspiration 8. The ‘rule of 15’ was defined to avoid regurgitation while using a SAD for laparoscopic surgeries (Trendelenburg tilt <15 degree; peritoneal insufflation <15 cm H 2 O; and duration of abdominal insufflation <15 minutes) 9. All our insufflations were performed in supine position with an abdominal insufflation pressure of 8-10 mm Hg, and all the procedures were completed in reverse Trendelenburg position.…”

Section: Discussionmentioning

confidence: 99%

AuraGain^™ and i-Gel^® laryngeal masks in general anesthesia for laparoscopic cholecystectomy

Sabuncu

Kuşderci

Öterkuş

et al. 2018

SMJ

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Objectives:To evaluate and compare the performances of new types of supraglottic airway devices (SADs) with endotracheal intubation regarding their ease of insertions, perioperative complications, and effects on hemodynamic parameters and peak airway pressures in laparascopic cholecystectomy (LC).Methods:One hundred and fourteen patients with ASA 1-2 physical status scheduled for elective LC were recruited for this prospective randomized controlled trial. The study was completed between January 2016 and January 2017 in Adiyaman University Research and Educational Hospital, Adiyaman, Turkey. The patients were divided into AuraGain™ (Ambu, Ballerup, Denmark) (n=38), i-Gel® (Intersurgical Ltd, UK) (n=35), and endotracheal tube (ETT) (n=32) groups. Ease of insertion, airway pressures, complications, and hemodynamic variables were compared.Results:The trial was completed with 105 patients. Ease of insertion for SADs which was evaluated with insertion procedure duration, attempts, first insertion success rates, and oropharyngeal leak pressures were similar between the groups. Heart rate, systolic and diastolic arterial pressures, and peak airway pressures were significantly lower in the AuraGain and i-Gel® groups, compared with the ETT, p<0.017.Conclusion:Both AuraGain and i-Gel® SADs are comparable with ETT used for airway control in general anesthesia for LC, regarding application ease and perioperative complications. Favorable hemodynamic responses to AuraGain and i-Gel® SADs may put them in a better place than ETT.

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Section: Discussionmentioning

confidence: 99%

AuraGain^™ and i-Gel^® laryngeal masks in general anesthesia for laparoscopic cholecystectomy

Sabuncu

Kuşderci

Öterkuş

et al. 2018

SMJ

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“…(12,17) A major concern of using LMAs in laparoscopic surgery is the risk of regurgitation and aspiration. (24) The incidence of regurgitation varies from 0.2-16.7% in previous reports with different SADs. (25)(26)(27) In this study, gastric re ux was noticed in ve patients (1.72%) in the drainage tube of the device at the end of surgery.…”

Section: Discussionmentioning

confidence: 98%

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

Liu

Song

Wang

et al. 2021

Preprint

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Backgroundː Laryngeal masks airway (LMA) has been increasingly used in surgical patients. However, the use of LMA in laparoscopic surgeries remains controversial. The major concerns include the potential risk of esophageal regurgitation, aspiration, and difficulties to achieve effective ventilation. The aim of this study was to evaluate the safety and effectiveness of the LMA® Protector™ in patients undergoing laparoscopic surgery. Methodsː Patients aged 18 to 70 years, scheduled for laparoscopic surgeries were included. The insertion time, successful insertion rate, and oropharyngeal leak pressure were measured. Airway complications and airway manipulations during the procedure were documented. Effective ventilation rate was calculated. Visible bloodstains and reflux content in the drainage channel were documented after the removal of LMA® Protector™. Resultsː A total of 300 patients were enrolled. The insertion of LMA® Protector™ failed in seven patients resulting with a successful insertion rate of 97.7%. During the maintenance of anesthesia, airway manipulation was required in 19 patients (19/293, 6.48%), in three of whom the LMA was replaced with endotracheal intubation resulting with an effective ventilation rate of 96.7% (290/300). The oropharyngeal leak pressure was 30.18±5.88 cmH2O. 75 patients (25.86%) reported mild sore throat on the first day after surgery. No signs of aspiration were noticed in any of those patients. Conclusionsː The LMA® Protector™ was shown to be safe and effective in patients undergoing laparoscopic surgeries. Although minor complications that requiring no further treatment, no clinically diagnosed aspiration was noticed in our study. Trial registration: The trail was registered at the Chinese Clinical Trial Registry (ChiCTR1800018300, data of registration, September 2018).

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“…The suprasternal notch test was performed as Eckardt described, [ 19 ] and a lubricated 14F gastric tube was then inserted through the female drainage port. Failed insertion of LMA® Protector™ was defined by any of the following criteria: [ 1 ] failed passage into the pharynx [ 2 ]; malposition (air leaks or end-tidal capnography could not be obtained); and [ 3 ] ineffective ventilation (maximum expired tidal volume < 8 ml/kg, end-tidal carbon dioxide > 45 mmHg, or pulse oxygen saturation < 92% if correctly positioned) [ 13 ]. We allowed a maximum of three attempts with the allocated device.…”

Section: Methodsmentioning

confidence: 99%

“…However, there remain some concerns with the use of LMA in laparoscopic surgery. The major concerns include the potential risk of gastroesophageal regurgitation, aspiration, and difficulties to achieve effective ventilation due to the influence of artificial pneumoperitoneum and postural changes on airway pressure and pulmonary compliance [ 1 , 2 ]. Therefore, many anesthesiologists advocate endotracheal intubation and mechanical ventilation for this kind of procedures despite evidences provided by previous studies.…”

Section: Introductionmentioning

confidence: 99%

LMA® protector™ in patients undergoing laparoscopic surgeries: a multicenter prospective observational study

et al. 2021

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Background Laryngeal masks airway (LMA) has been increasingly used in surgical patients. However, the use of LMA in laparoscopic surgeries remains controversial. The major concerns include the potential risk of esophageal regurgitation, aspiration, and difficulties to achieve effective ventilation. The aim of this study was to evaluate the safety and effectiveness of the LMA® Protector™ in patients undergoing laparoscopic surgery. Methods Patients aged 18 to 70 years, scheduled for laparoscopic surgeries were included. The insertion time, successful insertion rate, and oropharyngeal leak pressure were measured. Airway complications and airway manipulations during the procedure were documented. Effective ventilation rate was calculated. Visible bloodstains and reflux content in the drainage channel were documented after the removal of LMA® Protector™. Results Three hundred patients were enrolled. The insertion of LMA® Protector™ failed in seven patients resulting with a successful insertion rate of 97.7%. During the maintenance of anesthesia, airway manipulation was required in 19 patients (19/293, 6.48%), in three of whom the LMA was replaced with endotracheal intubation resulting with an effective ventilation rate of 96.7% (290/300). The oropharyngeal leak pressure was 30.18 ± 5.88 cmH2O. Seventy-five patients (25.86%) reported mild sore throat on the first day after surgery. Bloodstains on study devices were noticed in 58 patients (20%). Seventy-five patients (25.86%) reported mild sore throat on the first day after surgery. Gastric reflux was noticed in the drainage tube in 5 patients (1.72%) with no signs of aspiration in any of those patients. Conclusions The LMA® Protector™ was shown to be safe and effective in patients undergoing laparoscopic surgeries. Although minor complications that require no further treatment, no clinically diagnosed aspiration was noticed in our study. Gastric reflux was noticed in the drainage tube in five patients undergoing laparoscopic gynecology surgery. Further research is needed to verify whether LMA® Protector™ is suitable for procedures in Trendelenburg position or other situations that a high risk of gastroesophageal reflux exists. Trial registration The trial was registered at the Chinese Clinical Trial Registry (ChiCTR1800018300, date of registration: September 2018).

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Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study

Abstract: Our current results suggest that the use of an LMA in healthy patients undergoing laparoscopic gynecological surgery may be safe. Future studies to confirm or refute our findings are warranted.

Cited by 11 publications

References 19 publications

AuraGain^™ and i-Gel^® laryngeal masks in general anesthesia for laparoscopic cholecystectomy

AuraGain^™ and i-Gel^® laryngeal masks in general anesthesia for laparoscopic cholecystectomy

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

LMA® protector™ in patients undergoing laparoscopic surgeries: a multicenter prospective observational study

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Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study

Abstract: Our current results suggest that the use of an LMA in healthy patients undergoing laparoscopic gynecological surgery may be safe. Future studies to confirm or refute our findings are warranted.

Cited by 11 publications

References 19 publications

AuraGain™ and i-Gel® laryngeal masks in general anesthesia for laparoscopic cholecystectomy

AuraGain™ and i-Gel® laryngeal masks in general anesthesia for laparoscopic cholecystectomy

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

LMA® protector™ in patients undergoing laparoscopic surgeries: a multicenter prospective observational study

Contact Info

Product

Resources

About

AuraGain^™ and i-Gel^® laryngeal masks in general anesthesia for laparoscopic cholecystectomy

AuraGain^™ and i-Gel^® laryngeal masks in general anesthesia for laparoscopic cholecystectomy