Comparative Evaluation of The Efficacy and Outcomes of The Proseal Laryngeal Mask Airway Versus The Endotracheal Tube Under Low Flow Anaesthesia

Abstract Introduction: Low-flow anaesthesia is becoming more popular due to its benefits, including lower costs, reduced atmospheric pollution, and improved conservation of heat and airway humidity. To create a leak-free semi-closed circuit system in low-flow anaesthesia, achieving an airtight seal between the airway device and the patient’s airway is crucial. Our study aimed to compare the safety and efficacy of two airway maintenance devices, P-LMA (ProSeal laryngeal mask airway) and ETT (Endotracheal tube), within the context of low-flow anaesthesia. Materials and methods: A prospective randomised, doubleblind study was conducted on 60 ASA grade I/II patients aged 20-50 and weighing 40-70 kg who underwent surgery with general anaesthesia. They were assigned to two groups: Group L used P-LMA, and Group ET used ETT. Oropharyngeal leak pressure, tidal volume, peak and plateau pressure, Fraction of inspired oxygen, End Tidal carbon dioxide, inspiratory as well as expiratory concentrations of Nitrous Oxide and Isoflurane, hemodynamic parameters, and complications were analysed statistically using Student’s t test. Results: The oropharyngeal leak pressure measured 29.46 ± 1.1 cm H2O in the P-LMA group, compared to 31.3 ± 0.5 cm H2O in the ETT group (P < 0.0001). Additionally, the expired nitrous oxide and isoflurane concentrations were considerably lower in the P-LMA group than in the ETT Group (P < 0.0001). While these differences were statistically significant, they were clinically insignificant. Conclusion: Low-flow anaesthesia is safe when using the ProSeal laryngeal airway or an endotracheal tube, but the ProSeal laryngeal mask results in fewer postoperative complications.