Postoperative nausea, vomiting, airway morbidity, and analgesic requirements are lower for the ProSeal laryngeal mask airway than the tracheal tube in females undergoing breast and gynaecological surgery.

BACKGROUND

We test the hypothesis that the frequency of postoperative nausea and vomiting is similar for the ProSeal laryngeal mask airway (LMA) and the tracheal tube.

METHODS

Two hundred consecutive female patients (ASA I-II, 18-75 yr) undergoing routine breast and gynaecological surgery were divided into two equal-sized groups for airway management with the ProSeal LMA or tracheal tube.

RESULTS

Ventilation was better and airway trauma less frequent for the ProSeal LMA. For the ProSeal group, the time spent in the post-anaesthesia care unit was shorter (69 vs 88 min, P < 0.0001); fewer doses of tropisetron were required in the post-anaesthesia care unit (P < or = 0.001) and ward (P = 0.004); morphine requirements were lower in the post-anaesthesia care unit (6.0 vs 8.1 mg, P = 0.005) and ward (6.1 vs 8.9, P = 0.004); nausea was less frequent at all times (overall: 13% vs 53%, P < 0.0001); vomiting was less frequent at 2 h (4% vs 18%, P = 0.003) and 24 h (5% vs 19%, P = 0.004); and sore throat was less frequent at all times (overall: 12% vs 38%, P < 0.0001).

CONCLUSIONS

The ProSeal LMA reduced the absolute risk of postoperative nausea and vomiting by 40% (53-13%). In patients without the need for morphine, the ProSeal LMA reduced the absolute risk of postoperative nausea and vomiting by 23% (37-14%). We conclude that the frequency of postoperative nausea, vomiting, airway morbidity, and analgesic requirements is lower for the ProSeal LMA than the tracheal tube in females undergoing breast and gynaecological surgery.