Abstract:

Objective To evaluate the efficacy of Supreme laryngeal mask airway （SLAM）on ventilation in patients undergoing gynaecological surgery under general anesthesia. Methods Eighty patients undergoing gynaecological surgery under general anesthesia were divided into SLAM group (group S) and tracheal intubation group (group T), with 40 patients in each group. SLAM was inserted after anesthesia induction in group S, and tracheal catheter was intubated under direct laryngoscope after anesthesia induction in group T. The general conditions of patients and the time and conditions of SLAM placement or tracheal catheter intubation were recorded. The heart rates (HR), mean arterial blood pressure (MAP), pulse oxygen saturation(SpO₂), end tidal carbon dioxide pressure (PETCO₂) and peak airway pressure (Ppeak) were monitored during operation. The airway seal effects at neutral position, flexed position, over-extension position and side position of SLAM were observed. Fiberoptic bronchoscope was inserted into the airway tube of SLMA to verify its position. The times of successful gastric tube placement and incidences of hypoxemia, nausea and vomiting, choking, hoarseness, sore throat and regurgitation of gastric contents after SLAM or tracheal catheter withdrawal were observed. The time of anesthesia, extubation and emergence was recorded. Results The time of intubation, extubation and emergence in group S was shorter than that in group T, and the incidences of hypoxemia, choking and sore throat in group S were lower than those in group T. No regurgitation of gastric contents took place in two groups. HR and MAP 1 min and 5 min after tracheal catheter intubation in group T were significantly higher than those in group S （P<0.05）. SpO₂, PETCO₂ and Ppeak of different time points in two groups were in the normal range, and there was no significant difference between two groups (P>0.05). The airway seal pressure was (25±4) cmH₂O in group S, and different head and neck position did not change the airway sealing effect in group S. The success rate of gastric tube insertion was 100%. Fiberoptic bronchoscopy showed that SLAM was in good position. Conclusion SLAM can provide reliable airway seal effect and adequate ventilation with less complications, which can be effectively applied in gynaecological surgery under general anesthesia with safety.

Key words: laryngeal mask airway, anesthesia, gynaecological surgery