Comparison of Ventilation and Haemodynamic Parameters between I-Gel and Proseal LMA in Adult Patients undergoing Laparoscopic Cholecystectomy under General Anaesthesia

Background: The Proseal Laryngeal Mask Airway (PLMA) has been used as a safe alternative to endotracheal tube for many laparoscopic procedures while the I-Gel is still being evaluated for its use in anaesthesia with positive pressure ventilation in laparoscopic surgeries. Our aim was to compare ventilation and hemodynamic parameters between I-Gel and PLMA. Methods: 50 patients were randomly assigned to one of two groups, namely, the group-A (Proseal, n = 25) and the group-B (I-Gel, n = 25). Premedication and anaesthesia technique was standardized in both groups. Airway device was inserted as per group allocation after induction of anaesthesia. Oropharyngeal Seal Pressure (OSP) was recorded. Airway pressures, compliance and resistance, tidal volumes were recorded after insertion of SGA device at 5 min intervals before pneumoperitoneum, 10 minute intervals during pneumoperitoneum and at 5 min intervals after release of pneumoperitoneum till removal of device. Heart rate, systolic, diastolic and mean blood pressure were recorded after insertion of the device, 1 min and every 5 min throughout the surger. Results: Demographic parameters were comparable. OSP was higher with group B (32.16 + 2.61 cmH2O, P<0.001). Peak and mean airway pressures increased in both groups during pneumoperitoneum, but Ppeak increased more in group-A (8.62 ± 1.59 cmH2O, P< 0.001) and Pmean increased more in group B (4.19 ± 1.00 cmH2O, P<0.001). Compliance decreased to greater extent in group B (19 ± 3.7 ml/cmH2O). PaCO2 was higher in group A during pneumoperitoneum.( 35.52 ± 1.89, p = 0.004). There was greater increase in heart rate, SBP, DBP, MAP following PLMA insertion. Adverse events were comparable in both groups. Conclusion: I-Gel is associated with lower peak airway pressures, EtCO2, PaCO2 and higher mean airway pressures during pneumoperitoneum compared to PLMA and hence may provide better ventilation. I-Gel provides better haemodynamic stability.