The comparison of hemodynamics and respiratory mechanics between flexible reinforced laryngeal mask airway and tracheal intubation in functional endoscopic sinus surgery / 复旦学报（医学版）

ABSTRACT

Objective To compare the hemodynamics and respiratory mechanics between flexible reinforced laryngeal mask airway (FRLMA) and tracheal intubation (TI) in functional endoscopic sinus surgery. Methods Forty-six patients (ASA) scheduled for selective functional endoscopic sinus surgery under general anesthesia were allocated randomly to either flexible reinforced laryngeal mask airway group (FRLMA, n=23) or tracheal intubation group (TI, n=23) with mechanical ventilation. MAP and HR were recorded before anesthesia induction, before intubation, after intubation immediately, before extubation and after extubation immediately. Parameters for respiratory mechanics included peak inspiratory pressure (PIP), plateau airway pressure (P_(plateau)), mean airway pressure (P_(mean)), positive end expiratory pressure (PEEP), peak inspiratory flow (FI_(max)), peak expiratory flow (FE_(max)), and end tidal CO_2 (P_(Et)CO_2). All of the above indicators were recorded 5, 10 and 15 minutes after intubation. Meanwhile, arterial gas analysis was examined. Complications such as aspiration, coughing, pharyngeal pain, hoarseness, muscular soreness and unseal of FRLMA were followed up 24 hours after extubation. Results MAP and HR were significantly higher in group TI than those in group FRLMA after intubation and extubation (P<0.05). PIP, P_(plateau), P_(mean) and VD/VT were significantly higher in group TI than those in group FRLMA (P<0.05). Complications such as coughing, pharyngeal pain and muscular soreness were significantly lower in FRLMA group than that in TI group (P<0.05). Conclusions The application of FRLMA on functional endoscopic sinus surgery is a simply handling method, with minor laryngeal stimulation during intubation and extubation, more stable hemodynamics, reliable respiratory mechanics and low incidence of postoperative upper airway complications.