Comparison Between the Protector™ Laryngeal Mask Airway and the Endotracheal Tube for Minimally Invasive Thyroid and Parathyroid Surgery

Abstract

Background Pharyngolaryngeal symptoms are a main concern after neck surgery. The Protector TM LMA is a new supraglottic airway device. The main purpose of this study was to evaluate whether application of the LMA Protector TM causes fewer pharyngolaryngeal symptoms than application of the endotracheal tube after minimally invasive total thyroidectomy and parathyroidectomy. Methods This prospective, randomized controlled trial involved one university and one private practice clinic, during the period from January 2017 until November 2017. The patients were randomly allocated to two groups: ETT and LMA. Main outcomes were Numerical Rating Scale scores of postoperative dysphagia, pharyngodynia, and incisional pain. Secondary outcomes were the frequency of rescue analgesia (paracetamol) consumption and emergence cough. Data were recorded in the post-anesthesia care unit and at 1, 6, 12, and 24 h after surgery. Results Data from 78 patients were included in the final analysis. Pharyngodynia scores were significantly lower in the LMA group, compared with the ETT group, at 1 h, 6 h and 12 h after surgery. Dysphagia and surgical incision pain scores were also significantly lower in the LMA group, compared with the ETT group, at 6 h and 12 h after surgery. The frequency of postoperative paracetamol consumption was significantly increased in the ETT group, compared with the LMA group. Finally, the LMA group had fewer episodes of emergence cough, compared with the ETT group. Conclusion The LMA Protector TM causes fewer pharyngolaryngeal symptoms than the ETT within 6 and 12 h after minimally invasive total thyroidectomy and parathyroidectomy. Trial registration ClinicalTrials.gov Identifier NCT03098667.

Efficacy of laryngeal mask airway against postoperative pharyngolaryngeal complications following thyroid surgery: a systematic review and meta-analysis of randomized controlled studies

“…After the exclusion of duplicated records (n = 35) and those which did not meet the inclusion criteria by title and abstract (n = 196), 12 studies with full-texts available were reviewed. Finally, seven trials involving 600 patients published from 2014 to 2022 were included for the current meta-analysis 9 , 12 , 13 , 18 , 26 – 28 . A flow diagram summarizing the process of study selection is demonstrated in Fig.…”

“…Focusing on thyroid surgery, several previous studies have also demonstrated the feasibility and safety of LMA in this patient population 9 , 18 . Nevertheless, the efficacy of LMA against postoperative pharyngolaryngeal complications was not investigated in a systematic approach.…”

Contrast of Laryngeal Mask Airway Versus Endotracheal Tube for Early Postoperative Recovery Following Laparoscopic Cholecystectomy

“…Patients were discharged the next day after surgery if they did not have a fever or dietary issues. Statistical analysis: A prior study found that morphine intake differed between the ETT and LMA groups, with the LMA group consuming 17 (7.2) milligrams versus the ETT group consuming 12.1 (4.9) milligrams during laparoscopic gynecological surgery [5]. The starting sample size estimate resulted in thirty patients in each group, with a five percent error and an eighty percent power.…”

“…When set side by sidewith the use of an endotracheal tube (ETT), lesser incidences of coughing and laryngospasm were seen as a result of airway devices. Lesser incidence of postoperative nausea, hoarseness and sore throat were also seen [5,6].…”

Efficacy of Laryngeal Mask Airway Compared to Endotracheal Tube: A Randomized Clinical Trial

“…Brain in 1981 and has been commercially used since 1988 (3)(4)(5). The advantages of LMA compared to tracheal intubation are no tracheal injury during tube installation and removal, less airway stimulation, less invasion of the airway tissue, easier installation, and efficient establishment (6)(7)(8)(9). Therefore, in adults, it is recommended to use LMA as a substitute for tracheal intubation, especially in patients with a history of intubation, the possibility of difficult intubation diagnosed by an anesthesiologist, and patients whose intubation has failed and venti-lation can be performed with a mask (10)(11)(12).…”