Comparison of postoperative complication between Laryngeal Mask Airway and endotracheal tube during low-flow anesthesia with controlled ventilation

Abstract

Objective: To compare the postoperative complications between Laryngeal Mask Airway (LMA) and endotracheal tube (ETT) during low-flow anesthesia with controlled ventilation. Methodology: Eighty adult Patients with ASA class I or II were randomly allocated into two forty-patient groups (ETT or LMA). Cuff pressure was monitored during anesthesia. After high uptake period, fresh gas flow (FGF) was decreased to 1 lit/min and isoflurane set to 1%. Monitoring during anesthesia included non-invasive blood pressure, ECG, ETCO2 and pulse oximetry. System leakage (>100 ml/min), rebreathing and any attempt to increase FGF to overcome the leak were monitored during anesthesia. Later, patients were extubated and transferred to Post Anesthesia Care Unit (PACU). In PACU, the incidence of sore throat, cough, difficulty in swallowing and shivering was monitored for all patients. Results: Leakage was observed in two and three cases in ETT and LMA groups respectively (P>0.05). Postoperative cough, sore throat and difficulty in swallowing were significantly less in LMA than ETT group. No significant difference was observed regarding ETCo2 values between 2 groups. Conclusion: If careful measures regarding insertion techniques, correct LMA position and routine monitoring of LMA cuff pressure are taken, LMA can be used as a safe alternative with lower incidence of post operation complication compared with ETT during low-flow controlled anesthesia with modern anesthetic machines.

Hemodynamic Changes After Intubation of Endotracheal Tube, LMA Classic™, and I-gel in Patients Candidates for Elective Eye Surgery

“…One of these methods is the use of supraglottic devices that are designed for the lower stimulation and prevention of injuries caused by the tracheal intubation to the soft tissues, teeth, and vocal cords (4)(5)(6). It seems that due to the non-placement of laryngeal mask airway (LMA) (Figure 1) within the trachea and less irritation caused, the complications of the procedure of endotracheal intubation are less (7)(8)(9).…”

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

“…Our hypothesis is further supported by many other studies. 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.…”

Postoperative sore throat in patients undergone head and neck surgeries under endotracheal intubation and laryngeal mask anaesthesia

“…Some studies report a higher incidence of gastric insufflations and anesthetic gas leak due to low seal pressure with LMA. 9 Apart from the POST and cough, there are postoperative nausea and vomiting, hemodynamic changes were affecting the heart rate and BP associated with general anaesthesia which is also less with LMA. 10 The cause for POST and cough is not clear.…”