General Anesthesia via Laryngeal Mask Airway in Laparoscopic Adjustable Gastric Banding (LAGB)

Background: The use of ProSeal(TM)LMA (PLMA) has been reported in obese patients undergoing abdominal surgery procedures but not yet in super obese undergoing LAGB. Methods: Since Sept. 2007, 10 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 calibration 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 mins. Immediate or intraoperative problems were encountered in 1 (10%) out of 10 patients (poor relaxation that made pneumoperitoneum more difficult). Surgeons rated analgesia as good or excellent in all 10 patients and muscle relaxation as good or excellent in 9 out of 10 patients. Surgeons rated overall satisfaction for the anesthetic technique as good or excellent in all 10 patients. Patient satisfaction with anesthetic technique was high and all 10 patients agreed or strongly agreed that they were satisfied. The awakening phase was prompt after surgery (< 5 minutes), post-op nausea and vomiting was absent in all the patients, who were able to stand and walk within one our after completion of surgery. Conclusion: 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.