Airway management effect of the new video laryngeal mask airway SaCoVLMTM in lateral laparoscopic urological surgery: A single center randomized controlled trial

Abstract

Abstract There are few pertinent researchs about the application of laryngeal mask airway (LMA) in lateral decubitus surgery. The aims of our study were to evaluate the effects of lateral position and pneumoperitoneum on oropharyngeal leak pressure (OLP) and ventilation efficiency for the LMA SaCoVLMTM. Patients undergoing elective retroperitoneal laparoscopic urological surgery were randomized 1:1 to the SupremeTM group or SaCoVLMTM group. The primary outcome was the OLP with LMA insertion. Secondary outcomes were the first-attempt success rate, insertion time, adjustment times, gastric tube success rate, LMA alignment accuracy, LMA removal time, regurgitation or aspiration, LMA blood staining, and incidence of adverse events 24 hours postoperatively. We recruited 70 patients to complete the study. Regardless of lateral position and pneumoperitoneum, OLP was higher in the SaCoVLMTM group (n = 35) than in the SupremeTM group (n = 35), with a median difference of 4-7 cmH2O. The first-attempt success rate of the SaCoVLMTM group was higher than that of the SupremeTM group (91.4% vs. 77.1%, risk ratio (RR): 1.19; 95% CI 0.96 to 1.46, P = 0.188). In the lateral position and pneumoperitoneum, although the new video LMA SaCoVLMTM has a higher OLP than LMA SupremeTM, both devices provide sufficient ventilation efficiency.