Effect of Pneumoperitoneum and Lateral Position on Oropharyngeal Seal Pressures of Proseal LMA in Laparoscopic Urological Procedures
Introduction: A sustained and effective oropharyngeal sealing with supraglottic airway is required to maintain the ventilation during laparoscopic surgery. Previous studies have observed the Oropharyngeal Seal Pressure (OSP) for Proseal Laryngeal Mask Airway (PLMA) after pneumoperitoneum in supi...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2017-02-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/9422/22168_CE(RA1)_F(T)_PFA(RK)_PF2(P_SY)_PF3(AG_OM).pdf |
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| author | Preeti Rustagi Geeta A. Patkar Anil Kumar Ourasang Bharati A. Tendolkar |
| author_facet | Preeti Rustagi Geeta A. Patkar Anil Kumar Ourasang Bharati A. Tendolkar |
| author_sort | Preeti Rustagi |
| collection | DOAJ |
| description | Introduction: A sustained and effective oropharyngeal sealing
with supraglottic airway is required to maintain the ventilation
during laparoscopic surgery. Previous studies have observed
the Oropharyngeal Seal Pressure (OSP) for Proseal Laryngeal
Mask Airway (PLMA) after pneumoperitoneum in supine and
trendelenburg position, where PLMA was found to be an effective
airway device. This study was conducted with ProSeal LMA, for
laparoscopic Urologic procedures done in lateral position.
Aim: To measure OSP in supine and lateral position and to
observe the effect of pneumoperitoneum in lateral position
on OSP. Secondary objectives were to assess adequacy of
ventilation and incidence of adverse events.
Materials and Methods: A total number of 25 patients of
American Society of Anaesthesiologists (ASA) physical status
II and I were enrolled. After induction of anaesthesia using
a standardized protocol, PLMA was inserted. Ryle’s tube
was inserted through drain tube. The position of PLMA was
confirmed with ease of insertion of Ryle’s tube and fibreoptic
grading of vocal cords. Patients were then put in lateral
position. The OSP was measured in supine position. This value
was baseline comparison for OSP in lateral position and that
after pneumoperitoneum. We assessed the efficacy of PLMA for
ventilation, after carboperitoneum in lateral position (peak airway
pressure, End Tidal Carbon dioxide (EtCO2
), SPO2
). Incidence
of adverse effects (displacement of device, gastric insufflation,
regurgitation, coughing, sore throat, blood on device, trauma)
was also noted.
Results: The OSP was above Peak Airway Pressure (PAP) in
supine (22.1±5.4 and 15.4±4.49cm of H2
O) and lateral position
(22.6±5.3 and 16.1±4.6).
After pneumoperitoneum, which was in lateral position, there
was statistically significant (p-value <0.05) increase in both PAP
(19.96±4.015) and OSP (24.32±4.98, p-value 0.03).
There was no intraoperative displacement of PLMA. There was
no event of suboptimal oxygenation. EtCO2
was always within
normal limits. Gastric insufflation was present in one patient. One
patient had coughing and blood was detected on device. Three
patients had throat discomfort post-operatively.
Conclusion: In this study, Oropharyngeal seal pressures with
PLMA were found to increase after pneumoperitoneum in lateral
position. PLMA forms an effective seal around airway and is
an efficient and safe alternative for airway management in
urological laparoscopic surgeries done in lateral position. |
| first_indexed | 2024-04-13T02:12:25Z |
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| id | doaj.art-297353f4290742439b6d29ca017957e2 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-13T02:12:25Z |
| publishDate | 2017-02-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-297353f4290742439b6d29ca017957e22022-12-22T03:07:15ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-02-01112UC05UC0910.7860/JCDR/2017/22168.9422Effect of Pneumoperitoneum and Lateral Position on Oropharyngeal Seal Pressures of Proseal LMA in Laparoscopic Urological ProceduresPreeti Rustagi0Geeta A. Patkar1Anil Kumar Ourasang2Bharati A. Tendolkar3Assistant Professor, Department of Anaesthesiology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India.Professor, Department of Anaesthesiology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India.Registrar, Department of Anaesthesiology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India.Professor and Head, Department of Anaesthesiology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India.Introduction: A sustained and effective oropharyngeal sealing with supraglottic airway is required to maintain the ventilation during laparoscopic surgery. Previous studies have observed the Oropharyngeal Seal Pressure (OSP) for Proseal Laryngeal Mask Airway (PLMA) after pneumoperitoneum in supine and trendelenburg position, where PLMA was found to be an effective airway device. This study was conducted with ProSeal LMA, for laparoscopic Urologic procedures done in lateral position. Aim: To measure OSP in supine and lateral position and to observe the effect of pneumoperitoneum in lateral position on OSP. Secondary objectives were to assess adequacy of ventilation and incidence of adverse events. Materials and Methods: A total number of 25 patients of American Society of Anaesthesiologists (ASA) physical status II and I were enrolled. After induction of anaesthesia using a standardized protocol, PLMA was inserted. Ryle’s tube was inserted through drain tube. The position of PLMA was confirmed with ease of insertion of Ryle’s tube and fibreoptic grading of vocal cords. Patients were then put in lateral position. The OSP was measured in supine position. This value was baseline comparison for OSP in lateral position and that after pneumoperitoneum. We assessed the efficacy of PLMA for ventilation, after carboperitoneum in lateral position (peak airway pressure, End Tidal Carbon dioxide (EtCO2 ), SPO2 ). Incidence of adverse effects (displacement of device, gastric insufflation, regurgitation, coughing, sore throat, blood on device, trauma) was also noted. Results: The OSP was above Peak Airway Pressure (PAP) in supine (22.1±5.4 and 15.4±4.49cm of H2 O) and lateral position (22.6±5.3 and 16.1±4.6). After pneumoperitoneum, which was in lateral position, there was statistically significant (p-value <0.05) increase in both PAP (19.96±4.015) and OSP (24.32±4.98, p-value 0.03). There was no intraoperative displacement of PLMA. There was no event of suboptimal oxygenation. EtCO2 was always within normal limits. Gastric insufflation was present in one patient. One patient had coughing and blood was detected on device. Three patients had throat discomfort post-operatively. Conclusion: In this study, Oropharyngeal seal pressures with PLMA were found to increase after pneumoperitoneum in lateral position. PLMA forms an effective seal around airway and is an efficient and safe alternative for airway management in urological laparoscopic surgeries done in lateral position.https://jcdr.net/articles/PDF/9422/22168_CE(RA1)_F(T)_PFA(RK)_PF2(P_SY)_PF3(AG_OM).pdfairwaylateral positionproseal laryngeal mask |
| spellingShingle | Preeti Rustagi Geeta A. Patkar Anil Kumar Ourasang Bharati A. Tendolkar Effect of Pneumoperitoneum and Lateral Position on Oropharyngeal Seal Pressures of Proseal LMA in Laparoscopic Urological Procedures Journal of Clinical and Diagnostic Research airway lateral position proseal laryngeal mask |
| title | Effect of Pneumoperitoneum and Lateral Position on Oropharyngeal Seal Pressures of Proseal LMA in Laparoscopic Urological Procedures |
| title_full | Effect of Pneumoperitoneum and Lateral Position on Oropharyngeal Seal Pressures of Proseal LMA in Laparoscopic Urological Procedures |
| title_fullStr | Effect of Pneumoperitoneum and Lateral Position on Oropharyngeal Seal Pressures of Proseal LMA in Laparoscopic Urological Procedures |
| title_full_unstemmed | Effect of Pneumoperitoneum and Lateral Position on Oropharyngeal Seal Pressures of Proseal LMA in Laparoscopic Urological Procedures |
| title_short | Effect of Pneumoperitoneum and Lateral Position on Oropharyngeal Seal Pressures of Proseal LMA in Laparoscopic Urological Procedures |
| title_sort | effect of pneumoperitoneum and lateral position on oropharyngeal seal pressures of proseal lma in laparoscopic urological procedures |
| topic | airway lateral position proseal laryngeal mask |
| url | https://jcdr.net/articles/PDF/9422/22168_CE(RA1)_F(T)_PFA(RK)_PF2(P_SY)_PF3(AG_OM).pdf |
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