Abstract :
Background: Proseal laryngeal mask airway (PLMA) is being used increasingly apart from its gold standard alternative endotracheal tube (ETT) in airway management during paediatric laparoscopy. Limited data is available on effects of carboperitoneum on hemodynamics and pulmonary mechanics in paediatric patients. We aimed to assess effect of carboperitoneum on hemodynamics and pulmonary mechanics in paediatric patients undergoing video-endoscopic surgeries when PLMA and ETT are used.
Materials and Methods: After ethics committee approval and consent, 60 patients aged 1-10 years scheduled for laparoscopic surgeries were included in study and randomly allocated to two groups of 30 each. Airway maintained with PLMA in first group and ETT in group II. Hemodynamic parameters and ventilatory parameters were recorded at different time intervals from prior to insertion of airway device till deflation of carboperitoneum.
Results: Statistically significant increased heart rate, systolic, diastolic, mean blood pressure was observed in ETT group as compared to PLMA group during airway insertion and during rest of study period changes were analogous in both groups. Ventilatory parameters saturation, peak inspiratory pressure (PIP), plateau pressure (PP) and ETCO2 were comparable in both groups except during post deflation period where PP, PIP and ETCO2 remained elevated.
Conclusion: Proseal-LMA can be equally good option in paediatric laparoscopy with better hemodynamic stability and ventilatory parameters as degree of changes caused by carboperitoneum in PLMA group was insignificant compared to ETT.
Keyword :
Proseal-LMA, Endotracheal tube, Paediatric laparoscopy, Airway pressure, Carboperitoneum.