Laryngeal Mask Airway Protector in Patients Undergoing Gynaecological Laparoscopy: A Comparative Study

Open Access

Abstract

Background: Gynaecological laparoscopy under general anaesthesia presents distinct anaesthetic challenges, with haemodynamic fluctuations closely linked to the choice of airway device. Endotracheal intubation (ETT) provokes sympathoadrenal stimulation, whereas the laryngeal mask airway (LMA) protector, a second-generation supraglottic airway device, may offer superior haemodynamic stability. Objective: The objective of this study was to compare haemodynamic responses, intraoperative variables and the adequacy of respiration and ventilation between the LMA protector and the endotracheal tube in female patients undergoing gynaecological laparoscopy. Methods & Materials: A quasi-experimental study was conducted at the Gynaecological Operation Theatre, Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangladesh Medical University, from April 2024 to September 2025. Sixty female patients aged 18 to 40 years with ASA physical status I to II undergoing elective gynaecological laparoscopy were enrolled and alternatively allocated into Group E (ETT, n=30) and Group L (LMA protector, n=30). Mean arterial pressure (MAP), heart rate (HR) and SpO2 were recorded in five perioperative time points while ETCO2 were recorded at three perioperative time points. Data were analyzed using SPSS version 26. Results: Sociodemographic characteristics were comparable between both groups. After airway device insertion, MAP was significantly lower in Group L (84.4 mmHg vs. 94.7 mmHg; p=0.003), as was HR (85.0 vs. 93.5 bpm; p=0.038). Post-extubation MAP (90.7 vs. 103.2 mmHg; p=0.001) and HR (94.9 vs. 103.9 bpm; p=0.006) were also significantly lower in Group L. Duration of anaesthesia and surgery were comparable between groups. No significant differences in SpO2 or ETCO2 were observed at any time point. Regarding postoperative complications, sore throat was significantly lower in group L, but no significant differences were observed in airway trauma, hoarseness of voice and dysphagia. Conclusion: The LMA protector provides superior intraoperative haemodynamic stability over endotracheal intubation without compromising respiratory parameters, supporting its suitability as an effective airway management alternative in gynaecological laparoscopy.