***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose The classic laryngeal mask airway ( LMA ) has a soft , silicone tube and the intubating laryngeal mask airway ( ILM ) has a rigid , silicone-coated steel tube . We compare postoperative pharyngolaryngeal morbidity  in patients r and omised to receive either device . Methods Sixty-five female patients ( ASA physical status class I or II , aged 18–80 yr ) undergoing balanced regional anesthesia for gynecological laparotomy expected to last one to two hours were r and omly assigned for airway management with the LMA or ILM . Intracuff pressure was maintained at 60 cm H2O . Postoperative pharyngolaryngeal morbidity ( sore throat , difficulty swallowing , sore mouth , sore neck/jaw , hoarseness ) was assessed at two , 24 and 48 hr by blinded investigators . Results The number of insertion attempts and duration of anesthesia was similar between groups . Sore throat was more common for the ILM at two hours ( 44 vs 15 % , P=0.01 ) , 24 hr ( 59 vs 21 % , P=0.008 ) and 48 hr ( 34 vs 3 % , P=0.005 ) . Sore mouth was more common for the ILM at two hours ( 16 vs 0 % , P=0.02 ) and 24 hr ( 12 vs 0 % , P=0.04 ) , but not at 48 hr ( 6 vs 3 % ) . Difficulty swallowing was more common for the ILM at two hours ( 25 vs 0 % , P=0.04 ) , but not at 24 hr ( 31 vs 3 % ) and 48 hr ( 12 vs 9 % ) . There were no differences in the incidence of sore jaw/neck ( ILM , 3–12 % ; LMA , 0–3 % ) and hoarseness ( ILM , 12–31 % ; LMA , 16–18 % ) . There was no correlation between postoperative pharyngolaryngeal morbidity and duration of anesthesia . Conclusion : Pharyngolaryngeal morbidity is more common with the ILM than the LMA following anesthesia lasting one to two hours . RésuméObjectifLe masque laryngé traditionnel ( ML ) possède un tube de silicone mou t and is que le masque laryngé d’intubation ( MLI ) comporte un tube de métal rigide enrobé de silicone . Nous comparons la morbidité pharyngolaryngée postopératoire chez des patientes qui ont accepté de recevoir , au hasard , l’un ou l’autre masque . MéthodeSoixantecinq femmes ( d’état physique ASA I ou II , de 18 à 80 ans ) devant subir une anesthésie régionale balancée pendant une laparotomie gynécologique , censée durer une ou deux heures , ont été réparties au hasard pour une intubation avec le ML ou le MLI . La pression à l’intérieur du ballonnet a été maintenue à 60 cm H2O . La morbidité pharyngolaryngienne postopératoire ( mal de gorge , difficulté d’avaler , irritation de la bouche , douleur au cou/à la mâchoire , enrouement ) a été évaluée à deux , 24 et 48 h par des expérimentateurs impartiaux . RésultatsLe nombre d’essais nécessaires pour insérer le masque et la durée de l’anesthésie ont été similaires dans les deux groupes . Le mal de gorge a été plus fréquent avec le MLI à deux heures ( 44 vs 15 % , P = 0,01 ) , à 24 h ( 59 vs 21 % , P = 0,008 ) et à 48 h ( 34 vs 3 % , P = 0,005 ) . L’irritation de la bouche a été plus fréquente aussi avec le MLI à deux heures ( I6 vs O% , P = 0,02 ) et à 24 h ( 12 vs 0 % , P = 0,04 ) , mais non à 48 h ( 6 vs 3 % ) . La difficulté d’avaler se retrouve plus souvent avec le MLI à deux heures ( 25 vs 0 % , P = 0,04 ) , mais non à 24 h ( 31 vs 3 % ) ni à 48 h ( 12 vs 9 % ) . L’incidence de douleur au cou/à la mâchoire n’a pas présenté de différence intergroupe ( MLI , 3 - 12 % ; ML , 0 - 3 % ) , ni l’enrouement ( MLI , 12 - 31 % ; ML , 16 - 18 % ) . Il n’y a pas eu de corrélation entre la morbidité pharyngo-laryngienne postopératoire et la durée de l’anesthésie . Conclusion La morbidité pharyngo-laryngienne est plus élevée avec le MLI qu’avec le ML à la suite d’une anesthésie qui dure une ou deux heures STUDY OBJECTIVE To compare the sympathetic and hemodynamic responses to intubation with either an  endotracheal tube ( ETT ) or laryngeal mask airway ( LMA ) . DESIGN Prospect i ve , r and omized , single-blinded study . SETTING The in vivo study was carried out in an experimental laboratory . PATIENTS 16 healthy male consenting volunteers , ages 20 to 31 years , were studied . INTERVENTIONS After placement of a radial artery catheter , ECG electrodes , and a recording needle in the peroneal nerve , subjects were anesthetized with propofol 2.5 mg/kg , paralyzed with vecuronium 0.15 mg/kg , and ventilated via mask for 5 minutes with oxygen and 0.5 MAC desflurane or 0.5 MAC isoflurane . A LMA or ETT was inserted and neurocirculatory responses were continuously recorded . MEASUREMENTS AND MAIN RESULTS Measurements of heart rate ( HR ) , mean arterial pressure ( MAP ) , and sympathetic nerve activity ( SNA ) were made at preintubation baseline and at the peak response after airway manipulation . The time to recovery to 20 % and 10 % of baseline MAP and HR also was measured . Neurocirculatory variables did not differ in either the LMA ( n = 7 ) or ETT ( n = 9 ) groups immediately prior to intubation . The ETT group demonstrated a 27 % HR increase and a 42 % MAP increase compared with a 12 % HR increase and a 23 % MAP increase in the LMA group . Muscle SNA increased 600 % in the ETT group versus 66 % in the LMA group ( p < 0.01 ) . The time to return MAP and HR to 20 % and 10 % of perintubation baseline was significantly longer in the ETT than the LMA group ( p < 0.01 ) . CONCLUSIONS Because of the substantial reduction in the neurocirculatory responses to the LMA versus ETT , the LMA may prove advantageous in patients in whom HR and MAP increases may predispose to adverse cardiac or cerebrovascular events We have evaluated if breathing spontaneously via a laryngeal mask airway is associated with a higher risk of gastro-oesophageal reflux compared with positive pressure ventilation via a laryngeal mask airway in 40 patients undergoing day-case gynaecological laparoscopy . Patients were allocated r and omly to receive either positive pressure ventilation or breathe spontaneously via a laryngeal mask airway . Using continuous oesophageal pH monitoring , three patients in the ventilated group and one in the spontaneous breathing group had gastrooesophageal reflux ( P = 0.29 ) . We found no evidence to suggest that breathing spontaneously via a laryngeal mask airway increased the risk of gastro-oesophageal reflux compared with positive pressure ventilation in this group of patients OBJECTIVE To investigate the use of Laryngeal Mask Airway ( LMA ) and its comparison with the endotracheal tube for positive pressure ventilation . SETTING A tertiary care teaching hospital . METHODS Fifty adult ASA I and II patients undergoing peripheral limb surgery were r and omly allocated to 2 groups for LMA or endotracheal tube insertion . A st and ardized anaesthetic technique was used . The groups were then compared regarding haemodynamic changes on insertion as well as removal of LMA and ETT and any complications that occurred were noted . RESULTS The haemodynamic response to insertion was significantly attenuated ( p < 0.05 ) in LMA group as compared to ETT group . The cardiovascular response to extubation was not significantly different between the groups . A higher incidence of coughing and mild hypoxaemia at extubation was noted in ETT group as compared to LMA group ( p < 0.05 ) and blood was detected in 4 cases after LMA removal . CONCLUSION It is concluded that the use of LMA during positive pressure ventilation is safe in selected cases . There is an attenuated haemodynamic response to insertion of LMA as compared to endotracheal tube which will be beneficial in certain patients e.g. , those with ischaemic heart disease , vascular disease and hypertensives Purpose To compare the efficacy of the ProSeal LMA ™ and SLIPA ™ supralaryngeal airways ( SLA ) with the st and ard tracheal tube ( TT ) in 150 consecutive day-case laparoscopic gynecological surgery procedures requiring general anesthesia . Methods One hundred and fifty patients were r and omized into three groups . An identical general anesthesia technique was used in all patients apart from the addition of muscle relaxants and reversal drugs in the TT group . Patients were excluded if there were risk factors for gastroesophageal reflux .  Ease of use , quality of seal , ventilation , systolic pressure , response to intubation , side effects and operating room time were assessed . Results Both ProSeal LMA ™ and SLIPA ™ were easy to insert ( 100 % success ) and ventilate with respective mean ( st and ard deviation ) maximum sealing pressures of 31 ( 4.6 ) and 30 ( 5.2 ) cmH2O ( P = 0.4 ) with no muscle relaxants . The seal quality in both ProSeal LMA ™ and SLIPA ™ permitted the use of low flows , 485 ( 291 ) and 539 ( 344 ) mL·min-1 ( P = 0.2 ) respectively , although in the TT group significantly lower flows [ 377 ( 124 ) mL·min-1 ] , ( P < 0.01 ) were achieved . Systolic pressure in the SLA groups was more stable in response to insertion than in the TT . With ProSeal ™ there was a lower incidence of sore throats than with TT ( 30 % vs 57 % ) , ( P < 0.05 ) , but there was a lesser difference as compared with SLIPA ™ ( 30 % vs 49 % ) , ( P > 0.05 ) . With both SLAs , there was a significant reduction in operating room time ( > three minutes ) , ( P < 0.001 ) . Conclusions These results suggest that the ProSeal LMA ™ ( reusable ) and SLIPA ™ ( single-use ) SLAs were easy to use without requiring muscle relaxants , and reduce operating room time compared to the TT technique in day case laparoscopies . RésuméObjectifComparer ľefficacité des canules supralaryngées ( CSL ) ProSeal LMA ™ et SLIPA ™ avec celle du tube endotrachéal ( TET ) régulier dans 150 interventions gynécologiques laparoscopiques consécutives nécessitant une anesthésie générale . MéthodeNous avons réparti 150 patientes au hasard en trois groupes . La même technique ďanesthésie générale a été appliquée chez toutes , sauf ľaddition de myorelaxants et de contre-myorelaxants avec le TET . Certaines ont été exclues s’il y avait des risques de reflux gastro-œsophagien . La facilité ďutilisation , ľétanchéité , la ventilation , la tension artérielle systolique , la réaction à ľintubation , les effets secondaires et le temps en salle ďopération ont été évalués . RésultatsĽinsertion des ProSeal LMA ™ et SLIPA ™ ( 100 % de succès ) et la ventilation ont été faciles avec une moyenne respective ( écart type ) maximale de pression ďétanchéité de 31 ( 4,6 ) et 30 ( 5,2 ) cmH2O ( P = 0,4 ) sans myorelaxants . La bonne étanchéité des ProSeal LMA ™ et SLIPA ™ a permis ďutiliser de faibles débits , respectivement de 485 ( 291 ) et 539 ( 344 ) mL·min-1 ( P = 0,2 ) , et significativement plus bas [ 377 ( 124 ) mL·min-1 ] , ( P < 0,01 ) avec le TET . La tension systolique chez les patients des groupes CSL , comparés au groupe TET , a été plus stable en réaction à ľinsertion de la canule . Avec le ProSeal ™ , comparé au TET , 
    Output:
    
For the patients receiving general anesthesia , the use of the LMA result ed in a statistically and clinical ly significant lower incidence of laryngospasm during emergence , postoperative hoarse voice , and coughing than when using an ETT .