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ORIGINAL ARTICLE
Year : 2016  |  Volume : 3  |  Issue : 3  |  Page : 143-150

Fiberoptic assessment of air-Q, i-gel, and ProSeal position during laparoscopic cholycystectomy


1 Department of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, Medical Research Institute, University of Alexandria, Alexandria, Egypt
2 Department of Anaesthesia, Medical Research Institute, University of Alexandria, Alexandria, Egypt

Correspondence Address:
Rana Abo-Alsoud El-Din Abo-Alsoud
313 Taksim Elkoda, Smouha, Sidi Gaber, Alexandria
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2356-9115.193407

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Background The cuffed tracheal tube was considered the gold standard in laparoscopic surgeries but it has many disadvantages. Several studies have reported the successful safe use of the supraglottic airway devices in patients undergoing laparoscopic surgery. Aim of the work This study was carried out to compare the fitting of i-gel, air-Q, and ProSeal supraglottic airway devices during laparoscopic cholycystectomy before and after pneumoperitoneum using a fiberoptic bronchoscope. Patients and methods This study was conducted on 60 adult patients undergoing elective laparoscopic cholycystectomy. Patients were selected for airway management with either i-gel (Intersurgical LTD, Wokingham, Berkshire, UK) (group I), air-Q (Cookags LLC, Mercury Medical, Clearwater, FL, USA) (group II), or ProSeal (Intavent Orthofix, Maidenhead, UK) (group III) using the closed envelop method. They were divided into three equal groups (20 patients in each group). Fiberoptic assessment was carried out before and after pneumoperitoneum in the supine position. Results There was no significant difference in fiberoptic grading between the three groups before insufflation, but after insufflation the fiberoptic grading of air-Q and proseal laryngeal mask airway (PLMA) was significantly better than that of i-gel (P=0.014 and 0.028, respectively). As regards leak volume, there was no significant difference between the three groups before insufflation. However, there was a significantly greater leak with i-gel in comparison with air-Q and PLMA (P=0.040 and 0.010, respectively) after insufflation. There was no significant difference in number of attempts to insertion on comparing the three groups. As regards intraoperative airway intervention, less intervention was observed with i-gel and PLMA in comparison with air-Q (P=0.017 and 0.027, respectively). With regard to airway sealing quality, there was better sealing with air-Q and PLMA in comparison with i-gel (P=0.018 and 0.047, respectively). There was significantly greater complication with air-Q in comparison with both i-gel and ProSeal (P=0.013 and 0.038, respectively).


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