ABSTRACT
Objective To compare the eficacy and safety of flexible laryngeal mask (FLMA) and endotracheal tube (ETT) in children undergoing adenoidectomy and tonsillectomy. Methods Forty children with snoring disease scheduled for selective adenoidectomy and tonsillectomy surgery under intravenous compound inhalation general an-esthesia were divided randomly into either FLMA group or ETT group. MAP,HR and SpO2 were recorded before an-esthesia induction(T0 ), 1 (T1 ),3 (T2 ),5 (T3 ) min after intubation,1(T4 ),3 (T5 ) min after extubation. Param-eters for respiratory mechanics included peak airway pressure (Ppeak ), mean airway pressure (Pmean ), end tidal CO2 (PetCO2 ),and airway sealing pressure. All of the above indicators were recorded 5 min (T6 ) after intubation, 10 (T7 ),20 (T8 ) min after put in mouth gag,5 (T9 ) min after removing mouth gag. Meanwhile,chievement ratio of first time insertion,incidence of regurgitation aspiration,bucking,laryngospasm,wheezing when extubation and af-ter extubation,anesthesia time,surgery time,extubation time were recorded. Complications such as nausea and vomi-ting,pharyngeal pain,hoarseness were followed up 24 hours after surgery. Results MAP, HR during T1 , T2 , T3 , T4 ,T5 were significantly higher in group T than T0 , and those in group FLMA (P<0.05). MAP, HR were not sig-nificantly changed in group FLMA during each time. Ppeak , Pmean was significantly lower in group FLMA than that in group ETT. The extubation time was shorter and the incidence of coughing and pharyngalgia after operation was low-er in group FLMA than that in group ETT. Conclusion Compared with endotracheal intubation, on the basis of not affecting surgical operation, FLMA is an effective, safe anesthesia for adenoidectomy and tonsillectomy surgery in children, with the advantages of hemodynamic stability, mild airway trauma,and is a easy handling method, with minor laryngeal stimulation during intubation and extubation, more stable hemodynamics, reliable respiratory me-chanics and low incidence of postoperative upper airway complications.
ABSTRACT
Objective To evaluate the efficacy of flexible laryngeal mask airway and sevoflurane in pediatric strabismus surgery. Methods Totally 60 children undergoing elective strabismus surgery were recruited and divided into two groups with 30 cases each by random digits table:group T, in which children accepted endotracheal tube intubation and combined intravenous and inhalation anesthesia with mechanically ventilation; and group F, in which children adopted both flexible laryngeal mask airway and inhalation anesthesia of sevoflurane with spontaneous breath. Airway peak pressure (Ppeak), average airway pressure (Pmean), blood pressure (Bp) and heart rate (HR) at induction (T1), 1 min (T2), 3 min (T3) and 5 min (T4) after induction, removal of endotracheal tube or laryngeal mask airway (T5), awaking time and extubation time, occurrence of cough, dysphoria and pharyngodynia from being awake to extubation, satisfaction of patients were recorded. Results When compared to baseline, systolic pressure was lower at T, and higher at T2, T3 and T5, and HR was higher at T2-T5 in group T(P< 0.05),Bp was lower at T1-T4 in group F (P < 0.05). Bp and HR at T2-T5 in group F were lower than those in group T (P < 0.05). The awaking time was (8.1 ?2.6) min, the extubation time was (12.6 ?3.2) min, the occurrence of cough and pharyngodynia was 66.7%(20/30), 40.0%( 12/30), the dysphoria (0-1 score) was 7 cases in group T,(5.2 ± 1.1) min, (6.3 ± 1.5) rain,0,6.7%(2/30),25 cases in group F. There were significant differences between two groups (P<0.05). The satisfaction of patients in group F was higher than that in group T, there was significant difference between two groups (P< 0.05). Conclusion Flexible laryngeal mask airway with sevoflurane could offer high efficacy in pediatric strabismus surgery.