Comparison of Classic and Proseal LMA in Anaesthetised and Paralysed Patients coming for Gynaecological Surgeries

SUMMARY: Laryngeal Mask Airway has come a long way since its introduction in the year 1988 with multiple modifications coming up. The Proseal LMA is one such modification of the Classic LMA which incorporates additional features like a dorsal cuff and a drain tube by virtue of which it forms a better seal around the larynx. But, as mentioned earlier, although newer versions are increasingly seen in the Anaesthesiologist’s armoury, the Classic LMA has its own place. Hence we have compared these two LMAs in terms of ease of insertion, the time taken for insertion, the number of attempts required for insertion, the fiberoptic view after the insertion, the oropharyngeal sealing pressure and complications. This study was performed on 60 ASA I-II physical status female patients who were undergoing elective short duration gynaecological surgeries under general Anaesthesia.The ethical committee approval and the patient’s consent were obtained before starting the study. The study was a single blinded randomised study and the observations were done by the author after inducing general anaesthesia with a standard protocol. We observed no significant difference between the two LMAs in terms of ease of insertion, number of attempts and time taken for insertion.The fiberoptic view was significantly better with the Proseal LMA. The Oropharyngeal sealing pressure also was significantly higher than that of Classic LMA. There was no difference in the two LMA s in terms of complication both intra and postop.The haemodynamic response on insertion was also found to be comparable between the 2 LMAs. CONCLUSION: We hereby conclude that, Proseal LMA not only gives a better anatomical fit in the laryngopharynx as compared to the Classic LMA but also allows significantly better ventilatory conditions as assessed by the fiberoptic view and the oropharyngeal sealing pressure, respectively. There is no statistically significant difference between the two LMAs in terms of ease of insertion, intraop and postop complications