COMPARISON OF HEMODYNAMIC CHANGES OF PROSEAL LMA AND ENDOTRACHEAL TUBE FOR LAPAROSCOPIC SURGERIES

Abstract

Background: Hemodynamic stability during airway management is a major concern in laparoscopic surgeries because pneumoperitoneum and patient positioning significantly increase sympathetic activity. Aim: The aim of this study was to compare the hemodynamic changes observed with the use of the ProSeal laryngeal mask airway and the endotracheal tube during elective laparoscopic surgeries. Methods: This prospective, randomized comparative study was conducted at the Department of Anaesthesiology, Government Medical College Srinagar, over a study period of 18 months from June 2024 to November 2025. Adult patients scheduled for elective laparoscopic surgeries under general anesthesia were randomly assigned to the ProSeal laryngeal mask airway group or the endotracheal tube group. Hemodynamic parameters were recorded at baseline, immediately after airway insertion, at 5 and 10 minutes after pneumoperitoneum, and at device removal. Results: A total of 120 patients were enrolled, with 60 in each group. Baseline hemodynamic values were comparable in both groups. Immediately after airway insertion, the endotracheal tube group demonstrated a mean rise in heart rate of 21 beats per minute compared to 8 beats per minute in the ProSeal laryngeal mask airway group. Systolic blood pressure increased by an average of 27 mmHg in the endotracheal tube group but only by 11 mmHg in the ProSeal group. During pneumoperitoneum at 10 minutes, mean arterial pressure remained significantly higher in the endotracheal tube group (98 ± 7 mmHg) compared with the ProSeal group (89 ± 6 mmHg). Recovery-phase changes also showed greater fluctuations in the endotracheal tube group, with a mean heart rate rise of 15 beats per minute compared to 5 beats per minute in the ProSeal group. Ventilation and oxygenation remained adequate with both devices, and no major airway complications were recorded. Conclusion: The ProSeal laryngeal mask airway produced significantly fewer hemodynamic alterations compared to endotracheal intubation during elective laparoscopic surgeries. It provided stable cardiovascular parameters during airway insertion, pneumoperitoneum, and recovery and ensured effective ventilation.