General anesthesia via laryngeal mask airway in laparoscopic gastric banding (LAGB)

Background The use of ProSealÔ LMA (PLMA) has been reported in obese patients undergoing abdominal surgery procedures but not yet in super obese undergoing LAGB. Methods Ten super-obese patients (mean BMI 61,7 kg/m2, range 58.3–68.5) underwent LAGB under general anesthesia with the PLMA and intravenous propofol. The conventional orogastric tube was replaced by a 14-G Salem gastric tube passed through the drainage tube of the PLMA. Outcome measures were O.R. times, surgeon evaluation of the adequacy of the anesthetic technique, and patient evaluation of postanesthesia satisfaction. Results Mean total times in the operating room was 42 + 12 min. Immediate or intraoperative problems were encountered in one (10%) of ten patients (poor relaxation that made pneumoperitoneum more difficult). Surgeons rated analgesia as good or excellent in all ten patients and muscle relaxation as good or excellent in nine out of ten patients. Surgeons rated overall satisfaction for the anesthetic technique as good or excellent in all ten patients. Patient satisfaction with anesthetic technique was high, and all ten patients agreed or strongly agreed that they were satisfied. The awakening phase was prompt after surgery (<5 min), postoperative nausea, and vomiting was absent in all the patients, who were able to stand and walk within 1 h after completion of surgery. Conclusions General anesthesia via PLMA with intravenous propofol is safe and effective for LAGB and yields to a high degree of satisfaction for patients and surgeons.