Airway management in laparoscopic cholecystectomy – a comparative analysis

Abstract

In this study, we aimed to compare supraglottic airway devices (Supreme and i-gel laryngeal mask) with tracheal tube with respect to airway control and efficiency in ventilation and oxygenation. The study included 325 patients of ASA I-II who underwent laparoscopic cholecystectomy. In group 1, the airway was secured using endotracheal intubation (115 patients). In group 2 (103 patients), LMA Supreme was applied, whereas i-gel mask was used for airway management in group 3 (107 patients). Monitoring parameters were recorded and compared using t-test, analysis of variance (ANOVA), Tukey’s test and χ2-test. The following parameters were monitored: Insertion time, number of attempts for device placement, oropharyngeal seal pressure, etc. Insertion time was longest in group 1 (14.7±1.65 s) as compared to group 2 (15.5±1.05 s) and group 3 (14.1±1.27 s); ANOVA test yielded a statistically significant difference (p<0.01). Insertion success rate was almost identical in all three groups (p=0.907, χ2-test). Comparison of oropharyngeal seal pressure between group 2 (35.95±2.92 cm H2O) and group 3 (36.47±1.43 cm H2O) yielded no statistical difference (p=0.314, t-test). Endotracheal tube, Supreme and i-gel laryngeal masks were shown to be equally efficient in airway management in laparoscopic cholecystectomy. All three devices enabled efficient ventilation and oxygenation despite certain pathophysiological changes associated with laparoscopy.