Comparison Between Proseal Laryngeal Mask Airway and Supreme Laryngeal Mask Airway in Laparoscopic Cholecystectomy: A Randomized Controled Trial

Background: Supraglottic airway devices (SADs) offer an alternative airway with improved airway seal, enabling higher airway pressures during positive pressure ventilation (PPV). We compared the safety and efficacy of laryngeal mask airway (LMA) Proseal and LMA Supreme in laparoscopic cholecystectomy. Materials and Methods: Eighty patients, 18-60 years, ASA grade 1 and 2 were randomly allocated into two groups of 40 each. After induction of anesthesia, LMA Supreme or LMA Proseal of appropriate size was then inserted randomly. Parameters like the ease of LMA insertion, OGT insertion; oropharyngeal leak pressure (OLP); hemodynamics, adequacy of ventilation were recorded. Complications, if any, were also recorded. Results: LMA Supreme was easier to insert than LMA Proseal. Gastric tube insertion was comparatively easier in LMA Supreme than LMA Proseal. The mean oropharyngeal leak pressure was higher with LMA Proseal (31.98 ± 2.49cmH2O) than with LMA Supreme (30.23 ± 3.65 cmH2O). Peak airway pressures were comparable for the two groups. There was comparatively more airway trauma (mucosal injury, sore throat) in LMA Proseal than LMA Supreme. Conclusion: A higher oropharyngeal leak pressure makes LMA Proseal a better choice than LMA Supreme in procedures with raised intragastric pressure.