Baska mask versus Proseal laryngeal mask trial

Background

Patients coming for surgical procedures on the day of surgery and leaving the hospital before the end of the day is gaining popularity. This is popularly called as Day Care Surgery or Ambulatory Surgery. Administration of general anesthesia to these patients may necessitate that their breathing passages remain patent and safely connected to anesthesia machine at all times during surgery. This is usually achieved by placing a tube with a cup at its distal end in the patient’s mouth. This cup has an inflatable rim to make a seal around the proximal opening of the patient’s breathing passage (trachea) called the glottis. Such a device is called supraglottic device as it is placed above the glottis. Laryngeal mask airway (cLMA) or its variant called the Proseal laryngeal mask (PLM) are the most commonly used supraglottic device during day care surgery.

Despite cLMA’s safety profile, the incidence of sore throat following the use of cLMA has been reported to be five times more than that with face mask when used in ambulatory surgery. This is mainly attributed to the pressure exerted by the inflatable cuff inside the mouth. A previous study in ambulatory surgical patients found postoperative sore throat in 9% and 10% of patients managed with a cLMA and PLM respectively.

Aim of the Study

Being without an inflatable cuff, the problem of sore throat due to excessive cuff pressure as observed with PLM is expected to be significantly reduced with the use of Baska Mask (BM) which is the most recently introduced supraglottic device in 2012. For the same reason, use of the BM should neither cause tissue trauma nor nerve damage.

The association between extended postoperative stay following day care ambulatory surgery under general anesthesia could be the result of discomfort from a sore throat early in the postoperative period making patients reluctant to go home.

We hypothesize that patients undergoing ambulatory day care surgery using BM will be associated with a reduced incidence of laryngopharyngeal morbidity as compared to following a standard, uniform general anesthetic technique.

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