Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1016/j.jclinane.2016.07.038 http://hdl.handle.net/11449/173753 |
Resumo: | Objective The use of pneumoperitonium and the placement of patients in Trendelenburg position are commonly cited reasons for the potential development of intraoperative regurgitation of gastric contents and the need for an endotracheal tube in laparoscopic surgery. The main objective of the current investigation was to evaluate the presence of regurgitation of gastric contents in the oropharynx of patients having laparoscopic gynecological surgery with a laryngeal mask airway (LMA). Design Prospective, observational clinical investigation. Interventions Not applicable. Measurements Healthy subjects having a laparoscopic gynecological surgery under general anesthesia with a ProSeal LMA were included in the study. An insufflation pressure of 15 mm Hg was established as the maximum intra-abdominal pressure for the pneumoperitonium, and patients were placed in Trendelenburg position at a 15° angle. The pH of secretions extracted from subjects' hypopharynx was measured at multiple time points during the surgical procedure. A pH of oropharynx secretions ≤4.1 indicated the regurgitation of gastric contents. Main results Eighty subjects were recruited and completed the study. The median (range) of pH measurements at any time (T3-T9) was 6.5 (5.5-7.0). The median (range) for the lowest pH for each subject was 6.0 (5.5-7.0). The lowest detected pH in the hypopharynx was not correlated (Spearman ρ) with total surgical time (P = .9), total pneumopertitonium time (P = .17), or total Trendelenburg position time (P = .47). Conclusions Our current results suggest that the use of an LMA in healthy patients undergoing laparoscopic gynecological surgery may be safe. Future studies to confirm or refute our findings are warranted. |
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Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational studyLaparoscopyLMARegurgitationObjective The use of pneumoperitonium and the placement of patients in Trendelenburg position are commonly cited reasons for the potential development of intraoperative regurgitation of gastric contents and the need for an endotracheal tube in laparoscopic surgery. The main objective of the current investigation was to evaluate the presence of regurgitation of gastric contents in the oropharynx of patients having laparoscopic gynecological surgery with a laryngeal mask airway (LMA). Design Prospective, observational clinical investigation. Interventions Not applicable. Measurements Healthy subjects having a laparoscopic gynecological surgery under general anesthesia with a ProSeal LMA were included in the study. An insufflation pressure of 15 mm Hg was established as the maximum intra-abdominal pressure for the pneumoperitonium, and patients were placed in Trendelenburg position at a 15° angle. The pH of secretions extracted from subjects' hypopharynx was measured at multiple time points during the surgical procedure. A pH of oropharynx secretions ≤4.1 indicated the regurgitation of gastric contents. Main results Eighty subjects were recruited and completed the study. The median (range) of pH measurements at any time (T3-T9) was 6.5 (5.5-7.0). The median (range) for the lowest pH for each subject was 6.0 (5.5-7.0). The lowest detected pH in the hypopharynx was not correlated (Spearman ρ) with total surgical time (P = .9), total pneumopertitonium time (P = .17), or total Trendelenburg position time (P = .47). Conclusions Our current results suggest that the use of an LMA in healthy patients undergoing laparoscopic gynecological surgery may be safe. Future studies to confirm or refute our findings are warranted.Department of Anesthesiology Royal Spanish Charitable Society/Hospital (Real Sociedade Espanhola de Beneficência/Hospital)Department of Anesthesiology Feiberg School of Medicine Northwestern UniversitySchool of Biosciences UNESPBahia School of Medicine and Public Health EBMSPDepartment of Anaesthesiology Botucatu Medical School of Medicine UNESPSchool of Biosciences UNESPDepartment of Anaesthesiology Botucatu Medical School of Medicine UNESPRoyal Spanish Charitable Society/Hospital (Real Sociedade Espanhola de Beneficência/Hospital)Northwestern UniversityUniversidade Estadual Paulista (Unesp)EBMSPLemos, JeconiasDe Oliveira, Gildasio S.de Pereira Cardoso, Hugo Eckner DantasLemos, Lavínia Dantas Cardoso Neiva [UNESP]de Carvalho, Lígia RaquelMódolo, Norma Suely Pinheiro [UNESP]2018-12-11T17:07:35Z2018-12-11T17:07:35Z2017-02-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article32-35application/pdfhttp://dx.doi.org/10.1016/j.jclinane.2016.07.038Journal of Clinical Anesthesia, v. 36, p. 32-35.1873-45290952-8180http://hdl.handle.net/11449/17375310.1016/j.jclinane.2016.07.0382-s2.0-849946032442-s2.0-84994603244.pdfScopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengJournal of Clinical Anesthesia0,484info:eu-repo/semantics/openAccess2024-08-14T13:20:38Zoai:repositorio.unesp.br:11449/173753Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-14T13:20:38Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study |
title |
Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study |
spellingShingle |
Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study Lemos, Jeconias Laparoscopy LMA Regurgitation |
title_short |
Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study |
title_full |
Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study |
title_fullStr |
Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study |
title_full_unstemmed |
Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study |
title_sort |
Gastric regurgitation in patients undergoing gynecological laparoscopy with a laryngeal mask airway: a prospective observational study |
author |
Lemos, Jeconias |
author_facet |
Lemos, Jeconias De Oliveira, Gildasio S. de Pereira Cardoso, Hugo Eckner Dantas Lemos, Lavínia Dantas Cardoso Neiva [UNESP] de Carvalho, Lígia Raquel Módolo, Norma Suely Pinheiro [UNESP] |
author_role |
author |
author2 |
De Oliveira, Gildasio S. de Pereira Cardoso, Hugo Eckner Dantas Lemos, Lavínia Dantas Cardoso Neiva [UNESP] de Carvalho, Lígia Raquel Módolo, Norma Suely Pinheiro [UNESP] |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Royal Spanish Charitable Society/Hospital (Real Sociedade Espanhola de Beneficência/Hospital) Northwestern University Universidade Estadual Paulista (Unesp) EBMSP |
dc.contributor.author.fl_str_mv |
Lemos, Jeconias De Oliveira, Gildasio S. de Pereira Cardoso, Hugo Eckner Dantas Lemos, Lavínia Dantas Cardoso Neiva [UNESP] de Carvalho, Lígia Raquel Módolo, Norma Suely Pinheiro [UNESP] |
dc.subject.por.fl_str_mv |
Laparoscopy LMA Regurgitation |
topic |
Laparoscopy LMA Regurgitation |
description |
Objective The use of pneumoperitonium and the placement of patients in Trendelenburg position are commonly cited reasons for the potential development of intraoperative regurgitation of gastric contents and the need for an endotracheal tube in laparoscopic surgery. The main objective of the current investigation was to evaluate the presence of regurgitation of gastric contents in the oropharynx of patients having laparoscopic gynecological surgery with a laryngeal mask airway (LMA). Design Prospective, observational clinical investigation. Interventions Not applicable. Measurements Healthy subjects having a laparoscopic gynecological surgery under general anesthesia with a ProSeal LMA were included in the study. An insufflation pressure of 15 mm Hg was established as the maximum intra-abdominal pressure for the pneumoperitonium, and patients were placed in Trendelenburg position at a 15° angle. The pH of secretions extracted from subjects' hypopharynx was measured at multiple time points during the surgical procedure. A pH of oropharynx secretions ≤4.1 indicated the regurgitation of gastric contents. Main results Eighty subjects were recruited and completed the study. The median (range) of pH measurements at any time (T3-T9) was 6.5 (5.5-7.0). The median (range) for the lowest pH for each subject was 6.0 (5.5-7.0). The lowest detected pH in the hypopharynx was not correlated (Spearman ρ) with total surgical time (P = .9), total pneumopertitonium time (P = .17), or total Trendelenburg position time (P = .47). Conclusions Our current results suggest that the use of an LMA in healthy patients undergoing laparoscopic gynecological surgery may be safe. Future studies to confirm or refute our findings are warranted. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-02-01 2018-12-11T17:07:35Z 2018-12-11T17:07:35Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1016/j.jclinane.2016.07.038 Journal of Clinical Anesthesia, v. 36, p. 32-35. 1873-4529 0952-8180 http://hdl.handle.net/11449/173753 10.1016/j.jclinane.2016.07.038 2-s2.0-84994603244 2-s2.0-84994603244.pdf |
url |
http://dx.doi.org/10.1016/j.jclinane.2016.07.038 http://hdl.handle.net/11449/173753 |
identifier_str_mv |
Journal of Clinical Anesthesia, v. 36, p. 32-35. 1873-4529 0952-8180 10.1016/j.jclinane.2016.07.038 2-s2.0-84994603244 2-s2.0-84994603244.pdf |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Journal of Clinical Anesthesia 0,484 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
32-35 application/pdf |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
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1808128175266332672 |