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- Title
Comparison of the oropharyngeal leak pressure between three second generation supraglottic airway devices during laparoscopic surgery in pediatric patients.
- Authors
Kumar, Abhyuday; Sinha, Chandni; Kumar, Neeraj; Kumar, Ajeet; Kumar, Bindey; Kumar, Amarjeet; Kumar, Rajnish
- Abstract
Background: Previous studies have shown Proseal LMA and I gel similar to endotracheal intubation in ventilatory ability in pediatric laparoscopic surgeries. Aims: The primary aim of this study was to assess whether there is a significant difference in the oropharyngeal leak pressure between Ambu Auragrain, I‐gel, and Proseal LMA during pediatric laparoscopic surgery. Methods: In this randomized controlled trial, 90 male patients of American Society of Anesthesiologists physical status I aged between 6 months and 10 years who were scheduled for laparoscopic single‐sided inguinal hernia repair were recruited and randomly allocated to three groups in which airway was secured with Ambu Auragain, I gel, or Proseal LMA. The primary outcome was oropharyngeal leak pressure. The secondary outcomes were peak pressures before and after pneumoperitoneum, fiberoptic view, insertion attempts, insertion time, manipulations, perioperative and postoperative anesthesia‐related problems. Continuous variables were compared using the one‐way analysis of variance or the Kruskal–Wallis test with post hoc Turkey analysis. Categorical and ordinal data were compared using the chi‐square test or Fisher's exact test. Results: Oropharyngeal leak pressure before pneumoperitoneum was higher with I gel as compared to Ambu Auragain (27.36 ± 5.72 cm of H2O vs 23.56 ± 5.72 cm of H2O) (p =.021) and PLMA (27.36 ± 5.72 cm of H2O vs 23.24 ± 4.35 cm of H2O) (p =.011). Oropharyngeal leak pressure after pneumoperitoneum was also higher with I gel as compared to Ambu Auragain (31.58 ± 4.35 cm of H2O vs 26.83 ± 5.00 cm of H2O) (p =.001) and Proseal LMA (31.58 ± 4.35 cm of H2O vs 27.03 ± 3.80 cm of H2O) (p =.002). Oropharyngeal leak pressures of Ambu Auragain and Proseal LMA were comparable. Postoperative complications were similar in all the supraglottic airway devices. No regurgitation or aspiration‐related problem was observed in our study. Conclusion: I gel had a higher oropharyngeal leak pressure than the other two supraglottic airway devices and therefore may represent a better choice in situations where higher ventilatory pressures may be necessary, for example, in extremes of weight trendelenburg position, etc. Clinical Trial Identifier: Clinical trial registry of India (CTRI/2018/11/016445).
- Subjects
INDIA; AMERICAN Society of Anesthesiologists; LAPAROSCOPIC surgery; PEDIATRIC surgery; CHILD patients; HERNIA surgery; LARYNGEAL masks; FISHER exact test
- Publication
Pediatric Anesthesia, 2022, Vol 32, Issue 7, p843
- ISSN
1155-5645
- Publication type
Article
- DOI
10.1111/pan.14447