Literature DB >> 22174483

Protection against aspiration of gastric contents: The laryngeal mask airway Proseal vs endotracheal tube.

Shivinder Singh1, Ravindra Chaturvedi, R N Shukla, Ratnesh Shukla.   

Abstract

Entities:  

Year:  2011        PMID: 22174483      PMCID: PMC3237166          DOI: 10.4103/0019-5049.89907

Source DB:  PubMed          Journal:  Indian J Anaesth        ISSN: 0019-5049


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Sir, We read with interest the article titled “The comparison of Proseal laryngeal mask airway and endotracheal tube in patients undergoing laparoscopic surgeries under general anaesthesia” by Saraswat and colleagues[1] in the March–April issue of IJA. The primary variables studied were oxygenation and ventilation, based on which the power of the study was calculated to be 0.9. However, the predominant concern in the comparison of the two devices is the risk for aspiration of gastric contents. The reported incidence of clinically significant pulmonary aspiration in healthy patients undergoing elective surgery with the Laryngeal Mask Classic (LMA-C) is 1 in 5,000 to 1 in 12,000.[23] This is a similar order of magnitude to the incidence with endotracheal tube (ETT) or facemask in ASA I or II patients undergoing elective surgery.[4] Based on this incidence, to prove that the Proseal laryngeal mask airway (PLMA) is as good as the ETT to prevent aspiration and, keeping the power of the study to a minimum of 0.8 using the formula for equivalence trials with α=0.05, the total number of patients required to be included in the study are 5781 in each group. Despite other reports of safe use of PLMA in large series,[25] there still is concern about the safety of this practice.[6] The present study is not adequately powered to conclude that the PLMA is a safe and suitable alternative as compared with ETT where pulmonary aspiration of gastric contents is concerned.
  5 in total

1.  The LMA, laparoscopic surgery and the obese patient - can vs should: Le ML, la chirurgie laparoscopique et le patient obése - pouvoir vs devoir.

Authors:  Richard M Cooper
Journal:  Can J Anaesth       Date:  2003-01       Impact factor: 5.063

2.  Clinical significance of pulmonary aspiration during the perioperative period.

Authors:  M A Warner; M E Warner; J G Weber
Journal:  Anesthesiology       Date:  1993-01       Impact factor: 7.892

3.  Survey of laryngeal mask airway usage in 11,910 patients: safety and efficacy for conventional and nonconventional usage.

Authors:  C Verghese; J R Brimacombe
Journal:  Anesth Analg       Date:  1996-01       Impact factor: 5.108

4.  The incidence of aspiration associated with the laryngeal mask airway: a meta-analysis of published literature.

Authors:  J R Brimacombe; A Berry
Journal:  J Clin Anesth       Date:  1995-06       Impact factor: 9.452

5.  The comparison of Proseal laryngeal mask airway and endotracheal tube in patients undergoing laparoscopic surgeries under general anaesthesia.

Authors:  Namita Saraswat; Aditya Kumar; Abhijeet Mishra; Amrita Gupta; Gyan Saurabh; Uma Srivastava
Journal:  Indian J Anaesth       Date:  2011-03
  5 in total

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