Comparison Of Gastric Insufflation Using Laryngeal Masks Versus Tracheal Intubation In Laparoscopic Gynecological Surgery By Ultrasound

Objective:Explore abdominal ultrasound monitoring the changes of the antral cross-sectional area before and after the operation using the Supreme laryngeal mask,I-gel laryngeal mask and tracheal catheter in patients with gynecological laparoscopic surgery,for patients with laparoscopic surgery to choose a more appropriate airway management method to provide a clinical basis.Methods:One hundred gynecological patients undergoing laparoscopic surgery under elective general anesthesia were selected,and 90 cases were finally completed.They were randomly divided into 3 groups: I-gel laryngeal mask group(group I,n = 30),LMA Supreme group(group S,n = 30).Tracheal tube group(T group,n = 30).The systolic blood pressure(SBP),Diastolic blood pressure(DBP)and heart rate(HR)of all patients were recorded in the basic state before induction(T1),after induction of anesthesia(T2),immediately after intubation(T3),after surgery(T4),and immediately after extubation(T5).The antral cross-sectional area(CSA)of each patient was also recorded before induction(T6),after induction(T7)and after operation(T8).The incidence of sore throat,dry throat,hoarseness,nausea and vomiting within 24 hours were recorded.Results:Ninety patients completed the study,and all had a good gastric antrum cross section,and no serious complications of reflux and aspiration occurred.The antral cross-sectional area was not significantly different among three groups in the moment of before induction(P=0.451),the moment of after induction(P=0.456)and the moment of after the surgery(P=0.195).The haemodynamic variables were significantlyhigher in the group T than in the group S and the group I after insertion(P<0.01)and after removal(P<0.01).In group T,SBP,DBP and HR were significantly higher immediately after intubation(T3)than after induction of anesthesia(T2)and immediately after extubation(T5)than after surgery(T4)(P <0.05).Complications occurring sore throat and hoarseness were statistically different among groups(P<0.0001).Sore throat was detected in none in the I-gel group compare to two patients(6.7%)in the LMA-Supreme group and fifteen patients(50%)in the tracheal tube group.Hoarseness was detected in one(3.3%)in the I-gel group compare to two patients(6.7%)in the LMA-Supreme group and eleven patients(36.7%)in the tracheal tube group.Conclusion: LMA-Supreme and I-gel do not cause obvious gastric insufflations and are enough to prevent aspiration.Thus they can be widely used as alternative to endotracheal intubation for the short laparoscopic gynecological surgery.