Airway Complications during Laparoscopic Surgery Under General Anesthesia Using Endotracheal Tube Versus Supraglottic Airway Device: A Prospective Comparative Study
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Background: Pneumoperitoneum during laparoscopic surgery under general anesthesia is known to cause a decrease in pulmonary compliance and increase in airway pressures. Traditionally, endotracheal tubes (ETTs) have been used because they create a definitive airway, while second generation supraglottic airway devices (SGAs) have been shown to seal the airway better and to drain the stomach with less stimulation of the airway. The aim of the present study was to compare the incidence of airway complications in ETT and SGA in elective laparoscopy. Methods: This was a prospective comparative study of 120 adult ASA physical status I-II patients undergoing elective laparoscopic surgery. Patients were randomized to either ETT (n=60) or SGA (n=60; second generation device with gastric drainage channel). The following were used: standardized induction, neuromuscular blockade, controlled ventilation, pneumoperitoneum pressure, and postoperative assessment. The main outcome was the composite of airway complications within 24 hours. Secondary outcomes were device insertion characteristics, ventilatory variables, hemodynamic responses, postoperative sore throat, cough, and hoarseness, nausea-vomiting, and PACU discharge time. Results: There were no differences in baseline characteristics between groups. The mean insertion time was significantly less for SGA than ETT (15.2±3.8 vs. 22.8±5.4 seconds; p<0.001). Peak airway pressure following pneumoperitoneum was similar (23.4±3.8 vs. 24.1±4.2 cmH2O; p=0.34), and the increase in mean arterial pressure during insertion was less with SGA (8.6±5.7 vs. 15.8±7.1 mmHg; p<0.001). The composite airway complication rate was significantly greater in the ETT group (43.3%) compared to the SGA group (20.0%) (p=0.006). Sore throat (31.7% vs. 11.7%; p=0.008), emergence cough (26.7% vs. 8.3%; p=0.009), and hoarseness (18.3% vs. 5.0%; p=0.024) were more frequent after ETT. None of the patients had aspiration, regurgitation or clinically significant bronchospasm. Conclusions: In the right adult patient undergoing elective laparoscopic surgery, second-generation SGA was effective for ventilation and was found to be associated with fewer postoperative airway complications and a more stable hemodynamic response than ETT.
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7167925338