Airway With Supreme Laryngeal Mask Versus Endotracheal Tube In General Anaesthesia For Elective Caesarean Section

OBJECTIVE: The aim of this study was to compare the clinic effects of supreme LMA versus endotracheal intubation in general anaesthesia for elective Caesarean section.METHODS:200 Non-obese parturients scheduled for elective Cesarean delivery were randomly divided into two groups: SLMA group(n=100) and ETT group(n=100). All parturients were induced with intravenous propofol 2.5mg/kg,succinylcholine 100 mg. Airway device placement occurred at 1 minute after induction. SLMA group insert supreme LMA and ETT group intubate the trachea via direct laryngoscopy. The anesthesia was maintained with 2%-3%sevoflurane-50% N2O-50% O2 in both groups. Mean arterial pressure(MAP) and heart rate(HR) were measured before induction(T0), 1 minute after induction(T1),2 minutes after induction(T2),3 minutes after induction(T3), 4 minutes after induction(T4), 5 minutes after induction(T5),6 minutes after induction(T6).We recorded the time to effective ventilation,the number of SLMA or ETT insertion attempts, the incidence of aspiration, and other anesthetic and obstetric outcomes.Postoperatively, we noted the presence of blood on the SLMA or ETT,postoperative sore throat and hoarseness.RESULTS: All SLMA insertions were successful, with 99(99%) inserted onfirst attempt and a time to effective airway of(17.12±3.54)sec. The SLMA had a shorter time to achieve an effective airway(17s vs 39s; P < 0.01). The seal pressure were(27.93±3.99)mbar and(28.57±3.39)mbar(P>0.05)and the highest maintenance peak airway pressure were(17.12±3.82)mbar and(16.78±3.31)mbar(P>0.05).Mean arterial pressure and HR were lower in SLMA group at time T2,T3,T4,T5. No statistical difference was noted in adverse events when comparing SLMA and ETT.We maintained ventilation and oxygenation in all parturients with a good seal and there was no evidence of aspiration. No significant differences were found in umbilical cord vein p H and Apgar scores. 4 parturients(4%) had blood on the both groups upon removal and the incidence of postoperative sore throat were 1% and 2%.CONCLUSIONS: The SLMA is more rapidly inserted and can decrease haemodynamic response to insertion. The SLMA is a useful alternative to tracheal intubation for elective Cesarean delivery, providing effective ventilation and a low incidence of side effects or complications.