Clinical Observation On Supreme LMA In Laparoscopic Surgery In Lateral Position

Objective: To observe the safety and efficacy when Supreme LMA usedin laparoscopic operation in lateral position.Methods: Eighty ASA ⅠorⅡ patients aged20-72, Mallampati I or Ⅱ,undergoing elective larparoscopic operation in lateral position were ramdomlyassigned to receive either Supreme LMA(group S) or the endotracheal tube forairway management, before induction, all the patients were administrated acapsule of methylene blue, after induction Supreme LMA or endotracheal tubewas inserted by a single experienced anesthesiologist.(1) The HR, SBP, DBPand MAP were recorded before catheter(base value T1), the moment beforecatheter immediately(T2),3minutes after catheter immediately(T3), themoment before extubation immediately（T4）and3minutes after extubationimmediately（T5）.(2) If there were regurgitation and aspiration during theoperation.(3)To record the fiberoptic bronchoscopy scores and airway sealingpressure of SLMA at horizontal and lateral position.(4) The VT, SPO2, PETCO2,airway pressure and air leaking were observed.(5) The complication of cough,sore throat, hoarseness and blood strain of the tube were also recorded.Results: Compared with T1SBP, HR, MAP in group S at T2, T4weresignificantly lower than group T.(p﹤0.05).The rate of regurgitation in group S was7.5%, group T was2.5%and there was no aspiration in both group. Theairway sealing pressure at horizon position （28.1±4.00）cm H20was higherthan that in lateral position（25.66±4.68）cm H20.Conclusion: Airway management in patients anesthetized in lateralposition was safe and efficient with the Supreme LMA, compared withendotracheal intubation, do not increase the rate of regurgitation andaspiration，provided the satisfactory ventilation as endotracheal tube. Thehaemodynamics was more stable in Supreme LMA group than endotrachealtube group. The cough rate was also lower in the group of SLMA.