Laparoscopy Clinical Trial
Official title:
Comparison of the Ambu AuraGain vs. LMA Supreme in Paralysed Patients Undergoing Gynecologic Laparoscopic Surgery in the Trendelemburg Position
The aim of the study is to compare the performance of two supraglottic airway devices (SGA),
the new Ambu AuraGain and the LMA Supreme, in sixty female patients undergoing gynaecologic
laparoscopy in the trendelemburg position.
Primary outcome is the airway seal pressure. Secondary outcomes are ease of insertion,
quality of ventilation, endoscopic view of the glottis, gastric tube passage and
complications.
The patients are randomly assigned to 2 groups:
- Group 1: Ambu AuraGain.
- Group 2: LMA Supreme, Teleflex
Procedure:
The investigation protocol contains the following sections:
1. Induction of anaesthesia. Intravenous infusion of remifentanil and propofol targeting
the effect site (2-4 ng/ml and 4-6 µg/ml respectively). No muscle relaxant will be used
for insertion of the SGA. Rocuronium 0.2 mg/Kg will be administered before initiation
of pneumoperitoneum.
2. Insertion of the SGAs. The size of the SGA device used is based on the manufacturers'
recommendations. All devices are deflated a lubricated prior to use. Once inserted, the
cuff is be inflated with a manometer up to 60 cm H20 Position of the device is adjusted
if needed. Data recorded: size of SGA, time an number of attempts.
3. Fibreoptic evaluation of the SGAs anatomical position: complete view of the vocal cords
(I), epiglottis visible inside, but not causing obstruction (II), epiglottis visible
and obstructing the glottic inlet (III), or glottic structures not identified (IV).
4. Functionality of the gastric drainage channel of the SGAs: passage of a 16 G size tube.
5. Measurement of airway seal pressure (oropharyngeal leak pressure (OLP): at baseline,
and at 15, 30 and 60 minutes. The maximum pressure allowed is 40 cm H2O.
6. Ventilatory mechanics and parameters are measured at baseline, and at 15, 30 and 60
minutes.
Perioperative complications: Hiccup, gastric distension, regurgitation / Aspiration,
airway obstruction, laryngospasm, dental, mucosal or tongue injury, hypoxia (SpO2 <
92%)
7. Removal of the SGAs: Presence of blood - 3 level grading (+/++/+++) Postoperative
complications: sore throat, hoarseness, dysphonia, dysphagia, dysphagia: 3-point scale
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Treatment
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