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Indian Journal of Anesthesia and Analgesia

Volume  7, Issue 1, January-February 2020, Pages 414-419
 

Original Article

Comparative Study of Three Techniques of Proseal Laryngeal Mask Airway (PLMA) Insertion In Patients Undergoing Elective Surgeries

S Navaneetha Krishnan1, M Prem Kumar2

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7120.56

Abstract

Background: The LMA has revolutionized airway management and its use are now standard practice in General Anesthesia. The rationale behind the study was to compare three techniques of Proseal Laryngeal Mask Airway (PLMA) insertion. Objectives: To assess the superiority of placement with three techniques of Proseal Laryngeal Mask Airway insertion with respect to 1. Number of attempts to successful placement 2. Insertion time 3. Oropharyngeal leak pressure 4. Fiber Optic Bronchoscopy (FOB) Grading. Materials and Methods: A randomized prospective comparative study was done for a period of 1 year. The study was carried out at Saveetha Medical College and Hospital. The study was conducted on 90 adult patients of either sex, in the age of 18–65years, belonging to ASA I and II with Modified Mallampati Score I & II posted for elective surgeries. Systemic sampling was used. All patients were kept on fasting for 8 hrs. SPSS version 20 was used for analysis. One-way ANOVA and Chi-square test was used for analysis. p - value of < 0.05 is considered statistically significant. Results: There was no significant difference between the three groups in terms of age, weight, ASA, MMS. The insertion time for Group-G was 22.5 ± 5.0 sec and Group-IT was 14.2 ± 3.3 sec which were significantly higher than Group D (11.37 ± 2.7 sec). GEB guided PLMA insertion was successful in 30/30 (100%) and IT guided insertion was also successful in 30/30 (100%) in the first attempt. Oropharyngeal leak pressure in Group IT (26 ± 3.3) and Group G (27.8 ± 2.3) was significantly higher when compared to Group D. Conclusion: We conclude that GEB-guided insertion and Introducer technique is comparable to digital technique in successful placement of PLMA. However, GEB and IT technique provides better airway seal compared to digital technique.


Keywords : Proseal LMA; General anesthesia, Oropharyngeal leak pressure; Fiber-optic grading; Gum elastic bougie.
Corresponding Author : M Prem Kumar