A comparative study of endotracheal tube, i-gel and proseal laryngeal mask airway in laparoscopic surgeries. (a prospective randomized comparative study)

Background: The mask of the I-Gel is designed anatomically to fit the perilaryngeal and hypo pharyngeal structures without the use of an inflatable cuff and has potential advantages including easier insertion and use, minimal risk of tissue compression and stability. Aim: To compare I-gel, LMA-Proseal and Endotracheal tube during laparoscopic surgeries (Haemodynamic changes and End tidal Carbon dioxide levels). Methods: Prospective Randomized Comparative study conducted on 120 patients between the age group of 20-50 years (male/female ) of ASA grade I, forty patients each in three groups scheduled for laparoscopic surgeries done under general anaesthesia in Fortis hospital, Shalimar bagh, New Delhi which receives patients from the urban areas as well as from surrounding rural areas of the Delhi National Capital Region (NCR). Results: Mean change in heart rate before and after insertion in group E was 83.00±3.99 and 98.83±4.03,in group P was 84.70±3.82 and 94.18±4.04 and in group I was 83.53±4.17 and 92.98±3.89.The mean change in systolic blood pressure before and after insertion in group E was 121.15±3.09 and 137.93±2.04,in group P was 121.45±2.93 and 132.05±2.63,in group I was 120.35±2.99 and 131.65± 3.62 and the mean change in mean blood pressure before and after insertion in group E was 97.38±2.62 and 111.48±2.62,in group P was 97.15±2.26 and 06.95±2.17,in group I was 96.75±1.85 and 106.00±2.36 respectively. This statistically significant (P<0.05) increase in heart rate, systolic and mean blood pressure was observed immediately after insertion of airway devices, persisted till 3 minutes after intubation and during the time of extubation in group E (endotracheal tube). However statistically significant (p<0.05) increase in the heart rate in group P (Proseal LMA) and group I (I gel) was only after insertion of device. Conclusion: We concluded that both I-gel and Proseal LMA showed similar efficacy with improved hemodynamic stability, maintaining ventilation and oxygenation during laparoscopic surgeries.I-Gel and Proseal LMA are better than Endotracheal tube in terms of lesser haemodynamic response and a low incidence of intraoperative and postoperative laryngopharyngeal morbidities.