Indian Journal of Anaesthesia

CLINICAL INVESTIGATION
Year
: 2013  |  Volume : 57  |  Issue : 1  |  Page : 25--30

ProSeal laryngeal mask airway improves oxygenation when used as a conduit prior to laryngoscope guided intubation in bariatric patients


Aparna Sinha, Lakshmi Jayaraman, Dinesh Punhani, Bishnu Panigrahi 
 Department of Anesthesia, Institute of Minimal Access, Metabolic and Bariatric Surgery, Max Super Speciality Hospital, 2 Press Enclave Road, Saket, New Delhi, India

Correspondence Address:
Aparna Sinha
Max Super Speciality Hospital, 2 Press Enclave Road, Saket, New Delhi 110 017
India

Background: The primary objective of this study was to compare the effect of ventilation using the ProSeal TM laryngeal mask airway (PLMA) with facemask and oropharyngeal airway (FM), prior to laryngoscopy, on arterial oxygenation in morbidly obese patients undergoing bariatric surgery. Methods: Forty morbidly obese patients were randomly recruited to either PLMA or FM. After pre-oxygenation (FiO 2 1.0) in the ramp position with continuous positive airway pressure of 10 cm H 2 O for 5 min, anaesthesia was induced. Following loss of jaw thrust oropharyngeal airway, the FM and PLMA were inserted. On achieving paralysis, volume control ventilation with PEEP (5 cm H 2 O) was initiated. The difficulty in mask ventilation (DMV) in FM, number of attempts at PLMA and laryngoscopy were graded (Cormack and Lehane) in all patients. Time from onset of laryngoscopy to endotracheal tube confirmation was recorded. Hypoxia was defined as mild (SpO 2 ≤95%), moderate (SpO 2 ≤90%) and severe (SpO 2 ≤85%). Results: Significant rise in pO 2 was observed within both groups ( P=0.001), and this was significantly higher in the PLMA ( P=0.0001) when compared between the groups. SpO 2 ≥ 90% ( P=0.018) was seen in 19/20 (95%) patients in PLMA and 13/20 (65%) in FM at confirmation of tracheal tube. A strong association was found between DMV and Cormack Lehane in the FM group and with number of attempts in the PLMA group. No adverse events were observed. Conclusion: ProSeal TM laryngeal mask airway as conduit prior to laryngoscopy in morbidly obese patients seems effective in increasing oxygen reserves, and can be suggested as a routine airway management technique when managing the airway in the morbidly obese.


How to cite this article:
Sinha A, Jayaraman L, Punhani D, Panigrahi B. ProSeal laryngeal mask airway improves oxygenation when used as a conduit prior to laryngoscope guided intubation in bariatric patients.Indian J Anaesth 2013;57:25-30


How to cite this URL:
Sinha A, Jayaraman L, Punhani D, Panigrahi B. ProSeal laryngeal mask airway improves oxygenation when used as a conduit prior to laryngoscope guided intubation in bariatric patients. Indian J Anaesth [serial online] 2013 [cited 2020 Feb 29 ];57:25-30
Available from: http://www.ijaweb.org/article.asp?issn=0019-5049;year=2013;volume=57;issue=1;spage=25;epage=30;aulast=Sinha;type=0