Teleflex | LMA - Better by Design

Authors

Publication

J Clin Anesth 2011; 23: 456-460.

Summary

• A study to evaluate the performance of the LMA Supreme™ in patients undergoing elective laparoscopic cholecystectomy with general anaesthesia
• Successful insertion of the LMA Supreme™ was achieved in all patients undergoing elective laparoscopic cholecystectomy
• The LMA Supreme™ was an effective and well-tolerated ventilation device in patients undergoing laparoscopic cholecystectomy

Objectives:

• To evaluate the performance of the LMA Supreme™ in patients undergoing elective laparoscopic cholecystectomy with general anaesthesia

Method:

• This was a prospective, observational study undertaken in fasted American Society of Anesthesiologists class 1-3 patients aged 18 years or older
• The insertion of the LMA Supreme™ was done by anaesthesiologists who had been appropriately trained in the use of the device prior to the study
  • The cuff was not deflated prior to insertion
• Outcomes of interest included
  • Ease of insertion of the device and the gastric tube
  • Oropharyngeal leak pressure
  • Frequency of sore throat in the post-operative period
  • Adverse events

Results:

• Overall, 100 patients were included in the study
  • The mean age and body mass index of patients (63% of whom were female) were 51 years and 27 kg/m², respectively
• The LMA Supreme™ was successfully inserted in all of the study participants
  • Insertion was successful on the first attempt in 91% of patients and on the second attempt in 9% of patients
• Aspects of the insertion of the LMA Supreme™ are shown in Table 1

Table 1. Aspects of insertion of the LMA Supreme™

• A gastric tube was successfully inserted via the drain tube in all of the study participants
  • Insertion of the tube was classified as ‘easy’ in 97% of patients
• All patients had initial ventilation quality that was classified as ‘effective’ and had adequate ventilation during the surgical procedure
• Intraoperative leaks were detected in 11 patients because of displacement of the device
• Mean peak airway pressure was always lower than the oropharyngeal leak pressure, regardless of the phase of surgery (Figure 1)

Figure 1. Mean peak airway pressure (n=100) (data are shown as mean ± standard deviation)

• There were no episodes of laryngeal stridor, laryngospasm, bronchospasm, hypoxia, cough, regurgitation or aspiration during the course of the study
• A sore throat (pain of <3 on a scale of 1-10) was reported by 12% and 17% of patients immediately after and two hours after surgery, respectively
  • Complaints of sore throat in the immediate post-operative period were not associated with blood or trauma on removal of the LMA Supreme™
• There were no reports of dysphagia or dysphonia

Conclusions:

• The LMA Supreme™ is an effective ventilation device in patients undergoing laparoscopic cholecystectomy
• The use of the LMA Supreme™ supported airway pressures greater than those reached during surgery
• A low frequency of complications and side effects was noted