Kumar Brijender, Gupta Bhanu, Thakur Aman, Rana Shelly, Garg Mohini, Nehria Maninder
Department of Anaesthesia, Dr. Rajendra Prasad Medical College, Kangra at Tanda, Himachal Pradesh, India.
Indian J Anaesth. 2022 Dec;66(12):842-848. doi: 10.4103/ija.ija_827_21. Epub 2022 Dec 20.
TheProSeal™ laryngeal mask airway (PLMA) and I-Gel™ are second-generation supraglottic airway devices (SADs). The Baska mask is a SAD having a non-inflatable cuff with a tendency to increase the perilaryngeal seal with an increase in airway pressures. This study compared the efficacy of I-Gel™, PLMA and Baska mask with respect to airway dynamics in patients scheduled for laparoscopic surgeries under general anaesthesia (GA).
Ninety patients, of American Society of Anesthesiologists physical status I and II, aged 20-65 years scheduled for laparoscopic cholecystectomy under GA were enroled. The patients were randomised into three groups: Group P (n = 30): airway secured using PLMA, Group I (n = 30): airway secured using I-Gel™ and Group B (n = 30): airway secured using Baska mask. The primary outcome was the change in dynamic compliance, and the secondary outcomes included insertion time, changes in peak inspiratory pressure (PIP) and oropharyngeal leak pressure (OLP) at different time intervals.
After insertion of the SADs, the dynamic compliance was highest in group B and least in the group I (p = 0.01). The maximum decrease in dynamic compliance was observed in group I. The insertion time for SAD placement was more in group P. The group B had least PIP as compared to groups P, I at insertion. After carboperitonium, groups P and B had comparable PIP, and group I had highest PIP (p = 0.001). OLP was highest in group B, whereas group I had least OLP.
The airway dynamics are better maintained with Baska mask as compared to the PLMA and I-Gel™.
ProSeal™喉罩气道（PLMA）和I-Gel™是第二代声门上气道装置（SADs）。巴斯卡面罩是一种SAD，其 cuff 不可充气，随着气道压力升高，喉周密封有增加的趋势。本研究比较了I-Gel™、PLMA和巴斯卡面罩在全身麻醉（GA）下行腹腔镜手术患者气道动力学方面的效果。
纳入90例美国麻醉医师协会身体状况为I级和II级、年龄20 - 65岁、计划在GA下行腹腔镜胆囊切除术的患者。患者被随机分为三组：P组（n = 30）：使用PLMA确保气道安全；I组（n = 30）：使用I-Gel™确保气道安全；B组（n = 30）：使用巴斯卡面罩确保气道安全。主要结局是动态顺应性的变化，次要结局包括插入时间、不同时间间隔的吸气峰压（PIP）变化和口咽漏气压（OLP）变化。
插入SADs后，B组的动态顺应性最高，I组最低（p = 0.01）。I组动态顺应性下降最大。P组放置SAD的插入时间更长。与P组、I组相比，B组插入时的PIP最低。注入卡巴胆碱后，P组和B组的PIP相当，I组的PIP最高（p = 0.001）。B组的OLP最高，而I组的OLP最低。
与PLMA和I-Gel™相比，巴斯卡面罩能更好地维持气道动力学。
