A Prospective Randomized Controlled Trial of the Laryngeal Mask Airway Versus the Endotracheal Intubation in the Thyroid Surgery: Evaluation of Postoperative Voice, and Laryngopharyngeal Symptom

Chun, Byung-Joon; Bae, Ja-Sung; Lee, So-Hui; Joo, Jin; Kim, Eun Sung; Sun, Dong‐Il

doi:10.1007/s00268-015-2995-7

Cited by 35 publications

(51 citation statements)

References 27 publications

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“…Literature describes the use of the LMA instead of the endotracheal tube particularly in difficulties with intubation. 5 The use of LMAs for thyroidectomy is well described.…”

Section: Discussionmentioning

confidence: 99%

Use of Laryngeal Mask Airway in Total Thyroidectomy in a Patient with Ocular Myasthenia and Graves’ Disease

Fernando¹,

Munasinghe²,

Shilpage³

et al. 2019

World Journal of Endocrine Surgery

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Background:The association between Graves' disease (GD) and ocular myasthenia (OM) is well known. Total thyroidectomy gives a permanent "cure" for GD and the literature reports a varying progression of myasthenia gravis (MG) in such patients after surgery. The main issue in patients with MG is the difficulties with the use of muscle relaxants during anesthesia. In the ensuing case report, a patient with OM and GD who had a total thyroidectomy under general anesthesia (GA) with laryngeal mask airway (LMA) without muscle relaxants is described. Case report: A 40-year-old man was clinically and biochemically diagnosed to have GD. Subsequently, he developed bilateral ptosis which was diagnosed as OM by a neurologist. Though his OM responded to treatment, his GD was not well controlled. He was admitted, monitored, and made euthyroid by adjusting the carbimazole dose. A decision was made to undertake total thyroidectomy for GD, with total intravenous anesthesia and Proseal® LMA without muscle relaxants following a discussion with the anesthetic team. A conventional total thyroidectomy was performed using nerve encountering, parathyroid preserving, and capsular dissection technique. The patient made an uncomplicated recovery. Conclusion: A technique combining total intravenous anesthesia and a LMA without muscle relaxants for thyroid surgery in a patient with MG has advantages over a standard method. The use of LMA in other thyroid surgeries must be further evaluated for future use. Clinical significance: Coexistence of MG and GD should be in mind when treating the patients with GD. Individualize the use of muscle relaxants in GA and best to avoid whenever possible.

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“…Literature describes the use of the LMA instead of the endotracheal tube particularly in difficulties with intubation. 5 The use of LMAs for thyroidectomy is well described.…”

Section: Discussionmentioning

confidence: 99%

Use of Laryngeal Mask Airway in Total Thyroidectomy in a Patient with Ocular Myasthenia and Graves’ Disease

Fernando¹,

Munasinghe²,

Shilpage³

et al. 2019

World Journal of Endocrine Surgery

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“…As we know, most patients with PE are juveniles who have a smaller trachea and are more prone to intubation-related adverse events. The incidence of side effects (laryngeal pain, hoarseness and dysphonia) related to ETT in the early postoperative period has been reported to range from 15% to 50% (19). In such cases, a supraglottic airway device may be preferable.…”

Section: Discussionmentioning

confidence: 99%

“…Peirovifar et al (20) reported that postoperative cough, sore throat and difficulty in swallowing were significantly less in the LMA compared to the ETT group. Chun et al (19) also reported that use of the LMA in general anesthesia for thyroid surgery had advantages over the ETT in decreasing patients' subjective and objective voice symptoms, reducing the duration of symptoms, and relieving laryngopharyngeal symptoms.…”

Section: Discussionmentioning

confidence: 99%

Use of laryngeal mask airway for non-endotracheal intubated anesthesia for patients with pectus excavatum undergoing thoracoscopic Nuss procedure

Mao

Cui

et al. 2016

J. Thorac. Dis.

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Background:The aim of the present study was to determine the safety and feasibility of the use of laryngeal mask airway (LMA) for non-endotracheal intubated anesthesia for patients with pectus excavatum (PE) undergoing thoracoscopic Nuss procedure.Methods: Between July 2015 and December 2015, 30 selected patients with PE were planned to undergo a thoracoscopic Nuss procedure using LMA for non-endotracheal intubated anesthesia in the Guangdong General Hospital. The clinical data were analyzed to evaluate the safety and feasibility of this technique.Results: Of the 30 selected patients, two were female, the mean age was 16.04±5.09 years and the average Haller index was 3.37±0.88. A total of 27 cases (90%) succeeded at the first attempt, one patient required conversion to an endotracheal tube (ETT) because of continuous air leak. The peripheral O 2 saturation (SpO 2 ), end-tidal carbon dioxide (EtCO 2 ) values, heart rate (HR), and mean arterial blood pressure (MAP) remained stable throughout the procedure in all cases. All of the 30 patients were successfully corrected without requiring conversion to an open surgery. Two patients experienced postoperative nausea and one reported a sore throat. Neither gastro-esophageal reflux nor in-hospital mortality occurred. Conclusions:The use of LMA for non-endotracheal intubated anesthesia for selected patients with PE undergoing thoracoscopic Nuss procedure is clinically safe and technically feasible. as intubation-related trauma, increased risk of pneumonia, impaired cardiac performance, postoperative nausea and voice hoarseness, have prompted some surgeons to prefer the thoracoscopic procedure under non-endotracheal intubated anesthesia. The laryngeal mask airway (LMA) is a relatively new device that was introduced to clinical practice in the 1980s. Unlike ETT, the LMA is supraglottic and usually inserted blindly, thereby avoiding laryngoscopy. Therefore, it inevitably causes less intubation-related adverse events, such as vomiting, cough, hoarseness, sore throat, increased risk of pneumonia and impaired cardiac performance.Considering these benefits, the choice of thoracoscopic Nuss procedure in combination with non-endotracheal intubated anesthesia could have the latent possibility of decreasing the invasiveness of the procedure and allowing quicker postoperative recovery. Therefore, we conducted the present study to determine the safety and feasibility of using the LMA for non-endotracheal intubated anesthesia for patients with PE undergoing the thoracoscopic Nuss procedure. Methods Patient recruitmentThe study was designed as a pilot study and approved by the Human Ethics Committee of Guangdong General Hospital (Guangzhou, China). Written informed consent was obtained from the parents or legal guardians after they had been informed about the investigational nature of the study, the differences between LMA and ETT, the possibility that require conversion to an ETT may be necessary during the procedure, and the foreseeable outcomes. Eligibility criteria included a de...

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“…That said, these devices are not devoid of their own risks to the oral cavity and vocal cords. 4 In addition, it has been shown that certain conditions can favour dysphonia or throat pain after short-term endotracheal intubation (Table).…”

Section: To the Editormentioning

confidence: 99%

Anesthetic considerations and airway management in professional singers: an “orphan disease”?

Errando

2015

Can J Anesth/J Can Anesth

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A Prospective Randomized Controlled Trial of the Laryngeal Mask Airway Versus the Endotracheal Intubation in the Thyroid Surgery: Evaluation of Postoperative Voice, and Laryngopharyngeal Symptom

Abstract: Use of the LMA in general anesthesia for thyroid surgery has advantages over the ETI in decreasing patients' subjective and objective voice symptoms, reducing the duration of symptoms, and relieving the laryngopharyngeal symptoms.

Cited by 35 publications

References 27 publications

Use of Laryngeal Mask Airway in Total Thyroidectomy in a Patient with Ocular Myasthenia and Graves’ Disease

Use of Laryngeal Mask Airway in Total Thyroidectomy in a Patient with Ocular Myasthenia and Graves’ Disease

Use of laryngeal mask airway for non-endotracheal intubated anesthesia for patients with pectus excavatum undergoing thoracoscopic Nuss procedure

Anesthetic considerations and airway management in professional singers: an “orphan disease”?

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