Comparison of LM-Supreme™ and endotracheal tube in patients undergoing gynecological laparoscopic surgery.

While laryngeal mask is widely used for laparoscopic interventions in some countries, concerns exist regarding pulmonary aspiration and inadequate ventilation. We compared the LM-Supreme™ (LM-S) with the endotracheal tube (ETT) for laparoscopic gynecological interventions in terms of ventilation parameters and gastric distention. This prospective randomized and double-blind study. The patients were divided into two groups: ETT (n = 50) and LM-S group (n = 50). All patients in the LM-S and ETT groups recieved total intravenous general anaesthesia and standard ventilation protocols. Ventilation parameters (airway peak pressure, mean airway pressure, end-tidal carbon dioxide, total volume, oropharyngeal leak pressure) and perioperative laryngopharyngeal morbidity were recorded before peritoneal insufflation, during and after the peroperative period. The mean airway pressure values in the ETT group 2 min after airway device insertion were significantly higher. The gastric distension after the laparoscope entered the abdomen in the LM-S group was found to be significantly lower. In the first hour postoperative sore throat, disphonia and dysphagia were statistically significantly higher in the ETT group. In our study we concluded that LM-S provides reliable endotracheal intubation in ASA I & II patients undergoing laparoscopic gynecological surgery under positive pressure ventilation.ClinicalTrials.gov ID NCT02127632.

Effectiveness of sugammadex for cerebral ischemia/reperfusion injury.

Cerebral ischemia may cause permanent brain damage and behavioral dysfunction. The efficacy and mechanisms of pharmacological treatments administered immediately after cerebral damage are not fully known. Sugammadex is a licensed medication. As other cyclodextrins have not passed the necessary phase tests, trade preparations are not available, whereas sugammadex is frequently used in clinical anesthetic practice. Previous studies have not clearly described the effects of the cyclodextrin family on cerebral ischemia/reperfusion (I/R) damage. The aim of this study was to determine whether sugammadex had a neuroprotective effect against transient global cerebral ischemia. Animals were assigned to control, sham-operated, S 16 and S 100 groups. Transient global cerebral ischemia was induced by 10-minute occlusion of the bilateral common carotid artery, followed by 24-hour reperfusion. At the end of the experiment, neurological behavior scoring was performed on the rats, followed by evaluation of histomorphological and biochemical measurements. Sugammadex 16 mg/kg and 100 mg/kg improved neurological outcome, which was associated with reductions in both histological and neurological scores. The hippocampus TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) and caspase results in the S 16 and S 100 treatment groups were significantly lower than those of the I/R group. Neurological scores in the treated groups were significantly higher than those of the I/R group. The study showed that treatment with 16 mg/kg and 100 mg/kg sugammadex had a neuroprotective effect in a transient global cerebral I/R rat model. However, 100 mg/kg sugammadex was more neuroprotective in rats.