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Second-generation supraglottic airway in laparoscopic donor nephrectomy.

Ja Eun Lee1, Ha Yeon Kim2, Kyo Won Lee3

  • 1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

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|May 24, 2023
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Summary

Second-generation supraglottic airway (SGA) devices offer a safe and effective alternative to endotracheal tubes (ETT) for laparoscopic donor nephrectomy (LDN). This study found SGA use reduced airway pressure and improved lung compliance in kidney donors.

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Area of Science:

  • Anesthesiology
  • Nephrology
  • Surgical Innovation

Background:

  • Supraglottic airway (SGA) devices may offer benefits over endotracheal tubes (ETT) such as reduced laryngospasm and coughing.
  • Limited research exists on SGA use specifically in laparoscopic donor nephrectomy (LDN).

Purpose of the Study:

  • To evaluate the safety and feasibility of using second-generation SGA devices in LDN.
  • To compare the outcomes of SGA versus ETT in LDN procedures.

Main Methods:

  • A comparative study involving adult kidney donors undergoing LDN between August 2018 and November 2021.
  • Donors were divided into ETT and second-generation SGA groups.
  • Propensity score matching was used to compare outcomes including airway pressure, lung compliance, desaturation, and hypercapnia.

Main Results:

  • Lower peak airway pressure observed in the SGA group post-pneumoperitoneum compared to the ETT group.
  • Higher dynamic lung compliance in the SGA group during surgery.
  • No instances of intraoperative desaturation, hypercapnia, or postoperative aspiration pneumonitis were reported in either group.

Conclusions:

  • Second-generation SGA is a safe and feasible alternative to ETT for airway management in LDN.
  • SGA use in LDN is associated with reduced airway resistance and enhanced lung compliance.
  • These findings suggest potential benefits of SGA for airway management in kidney donors.