A prospective randomised comparative study of proseal LMA, I-gel and endotracheal tube in laparoscopic cholecystectomy

Introduction: The major responsibility of the anesthesiologist is to provide adequate ventilation to the patient because airway related problems are still the most common cause of anaesthesia related morbidity and mortality. The use of I-gel has been reported in laparoscopic surgeries and was found equally effective ventilatory device as PLMA. Therefore, we planned this study to compare I-gel and PLMA with ET tube in patients undergoing laparoscopic cholecystectomy. Materials and Methods: This prospective study was conducted on 90 patients of both sex, 18-60 years age, ASA grade I-II, scheduled for elective laproscopic surgery under general anaesthesia. All patients were randomised into three groups of 30 patients each; Group I (I-gel), Group P (PLMA), Group E (ET Tube). Attempts of insertion of devices, effective airway time and easiness of gastric tube; hemodynamic parameters (HR, MAP, SpO2 and EtCO2) were recorded. Results: There was significantly less 2nd attempt required in I-gel group(10%) as compared with ET tube (36.7%) and PLMA (13.3%),(p=0.019). Laryngopharyngeal morbidity were significantly more in Group E as compared to Group P and I (p<0.05). Hemodynamic changes were significantly higher in Group E immediately after intubation which persisted for 3 minutes and immediately after extubation (p= 0.00). Conclusion: Supraglottic Airway Devices (PLMA and I-gel) were as effective as ET tube in establishing airway and the haemodynamic stability is better then ET tube in laparoscopic cholecystectomy.