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BJA Advance Access originally published online on July 6, 2007
British Journal of Anaesthesia 2007 99(4):576-580; doi:10.1093/bja/aem096
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Postoperative nausea, vomiting, airway morbidity, and analgesic requirements are lower for the ProSeal laryngeal mask airway than the tracheal tube in females undergoing breast and gynaecological surgery

M. Hohlrieder1, J. Brimacombe2,*,{dagger}, A. von Goedecke1 and C. Keller1,{dagger}

1 Department of Anaesthesia and Intensive Care Medicine, Medical University Innsbruck, Austria
2 Department of Anaesthesia and Intensive Care, Cairns Base Hospital, James Cook University, The Esplanade, Cairns 4870, Australia

* Corresponding author. E-mail: jbrimaco{at}bigpond.net.au

Background: We test the hypothesis that the frequency of postoperative nausea and vomiting is similar for the ProSeal laryngeal mask airway (LMA) and the tracheal tube.

Methods: Two hundred consecutive female patients (ASA I–II, 18–75 yr) undergoing routine breast and gynaecological surgery were divided into two equal-sized groups for airway management with the ProSeal LMA or tracheal tube.

Results: Ventilation was better and airway trauma less frequent for the ProSeal LMA. For the ProSeal group, the time spent in the post-anaesthesia care unit was shorter (69 vs 88 min, P < 0.0001); fewer doses of tropisetron were required in the post-anaesthesia care unit (P ≤ 0.001) and ward (P = 0.004); morphine requirements were lower in the post-anaesthesia care unit (6.0 vs 8.1 mg, P = 0.005) and ward (6.1 vs 8.9, P = 0.004); nausea was less frequent at all times (overall: 13% vs 53%, P < 0.0001); vomiting was less frequent at 2 h (4% vs 18%, P = 0.003) and 24 h (5% vs 19%, P = 0.004); and sore throat was less frequent at all times (overall: 12% vs 38%, P < 0.0001).

Conclusions: The ProSeal LMA reduced the absolute risk of postoperative nausea and vomiting by 40% (53–13%). In patients without the need for morphine, the ProSeal LMA reduced the absolute risk of postoperative nausea and vomiting by 23% (37–14%). We conclude that the frequency of postoperative nausea, vomiting, airway morbidity, and analgesic requirements is lower for the ProSeal LMA than the tracheal tube in females undergoing breast and gynaecological surgery.

Keywords: complications, sore throat; vomiting, nausea

{dagger} Declaration of interest. Drs J. Brimacombe and C. Keller have worked as consultants for the laryngeal mask company.


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Pharyngeal stimuli and postoperative nausea and vomiting
john c boncyk
British Journal of Anaesthesia, 20 Feb 2008 [Full text]
Reply
Joseph R Brimsacombe, et al.
British Journal of Anaesthesia, 29 Feb 2008 [Full text]

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