Comparison of ProSeal laryngeal mask airway, classical laryngeal mask airway with endotracheal tube in gynecological laparoscopy under controlled ventilation


  • Anupkumar S. Patel Consultant Anaesthesiology, Sanjeevani Hospital, Borsad, Vadodara, Gujarat, India
  • Namrata Jain Department of Anaesthesiology, CHRI, Gwalior, Madhya Pradesh, India



CLMA, Classical laryngeal mask airway, PLMA, ProSeal laryngeal mask airway


Background: PLMA is a recent, complex, and ingenious development with some added feature of classic LMA like modified dual cuff, drain tube, positive pressure ventilation at higher peak inspiratory pressure. Study was to evaluate and compare the use of classical laryngeal mask airway, ProSeal laryngeal mask airway, and endotracheal tube with controlled ventilation in patients undergoing gynecological laparoscopic procedure.

Methods: About 150 patients, ASA risk I and II, posted for elective gynecological laparoscopy were recruited in the study. All the patients between 18 to 45years of age were randomly divided in three groups, group PLMA, group CLMA, group ETT (50 patients each). Attempt of insertion of airway device, leaks pressure, pulmonary ventilation, hemodynamic; heart and MAP, gastric distention was recorded. All patients were of middle age group, comparable in weight. Mean duration of laparoscopy was comparable in all the groups.

Results: Significant rise in heart rate and mean arterial pressure seen in group ETT after induction of anesthesia. Changes in the end tidal CO2 and peak airway pressure after induction of anesthesia, before and after pneumoperitonium were comparable in all three groups. After head low position peak airway pressure is slightly raised in group PLMA, group CLMA. Gastric distension was noted higher in group 10 % as compare to group PLMA (8%) and group (2%). Incidence of sore throat (22%), nausea vomiting (14%) and airway trauma (14%) was higher in group ETT.

Conclusions: Hemodynamic stability was better in and CLMA group at time of induction and comparable in all three groups at time of pneumoperitoneum and trendelenburg position along with pulmonary ventilation. Post-operative sore throat, nausea vomiting was higher with endotracheal tube.


Shroff P, Surekha K. Randomized comparative study between the proseal laryngeal mask airway and the endotracheal tube for laparoscopic surgery. Internet J Anesthesiol. 2006;11.

Sharma B, Sahai C, Bhattacharya A, Kumar VP, Sood J. ProSeal laryngeal mask airway: a study of 100 consecutive cases of laparoscopic surgery. Ind J Anaes. 2003;47(6):467-72.

Saraswat N, Kumar A, Mishra A, Gupta A, Saurabh G, Srivastava U. The comparison of ProSeal laryngeal mask airway and endotracheal tube in patients undergoing laparoscopic surgeries under general anaesthesia. Ind J Anaes. 2011;55:129-34.

Brain AI, Verghese C, Strube PJ. The LMA ‘ProSeal’-a laryngeal mask with an oesophageal vent. Brit J Anaes. 2000;84(5):650-4.

Maltby JR, Beriault MT, Watson NC, Liepert D, Fick GH. The LMA-ProSeal™ is an effective alternative to tracheal intubation for laparoscopic cholecystectomy. Can J Anes. 2002;49(8):857-62.

Maltby JR, Beriault MT, Watson NC, Liepert DJ, Fick GH. LMA-Classic™ and LMA-ProSeal™ are effective alternatives to endotracheal intubation for gynecologic laparoscopy. Can J Anes. 2003;50(1):71-7.

Lim Y, Goel S, Brimacombe JR. The ProSeal (TM) laryngeal mask airway is an effective alternative to laryngoscope-guided tracheal intubation for gynaecological laparoscopy. Anaes Intensive Care. 2007;35:52-6.

Evans NR, Gardner SV, James MF, King JA, Roux P, Bennett Pet al. The ProSeal laryngeal mask: results of a descriptive trial with experience of 300 cases. Brit J Anaes. 2002;88(4):534-9.

Sharma B, Sood J, Kumra VP. Uses of LMA in present day anaesthesia. J Anaesthesiol Clin Pharmacol. 2007;23(1):5.

Sharma B, Sood J, Sahai C, Kumra VP. Efficacy and safety performance of ProsealTM laryngeal mask airway in laparoscopic surgery: experience of 1000 cases. Ind J Anaes. 2008;52(3):288-96.

Brimacombe J, Keller C. The ProSeal laryngeal mask airway. randomized, crossover study with the standard laryngeal mask airway in paralyzed, anesthetized patients. Anesthesiology: J Am Society Anesthesiol. 2000;93(1):104-9.

Brimacombe J, Keller C, Boehler M, Pühringer F. Positive pressure ventilation with the ProSeal versus classic laryngeal mask airway: a randomized, crossover study of healthy female patients. Anes Anal. 2001;93(5):1351-3.

Brimacombe J, Keller C. The ProSeal laryngeal mask airway. Anesthesiol Clini North Am. 2002;20(4):871-91.

Maltby JR, Beriault MT, Watson NC, Liepert D, Fick GH. The LMA-ProSeal™ is an effective alternative to tracheal intubation for laparoscopic cholecystectomy. Can J Anes. 2002;49(8):857-62.






Original Research Articles