Zhang Xuyu, Feng Xia, Wu Xiaodan, Liu Zimeng, Zhang Hufei, Liu Xinhe
Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, Guangdong 510089, China.
Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan 2nd Road, Guangzhou, Guangdong 510089, China.
ScientificWorldJournal. 2013 Nov 28;2013:461023. doi: 10.1155/2013/461023. eCollection 2013.
The aim of this study was to detect the effect of the laryngeal mask airway (LMA) versus the endotracheal tube (ETT) on postoperative nasal bleedings in and outside the operation room (OR) after intranasal surgery.
134 patients undergoing elective intranasal surgeries were randomly allocated to receive LMA or ETT during general anesthesia. The incidence, episodes, and severity of nasal bleeding were evaluated in the OR and within the postoperative 24 hours in the ward. Furthermore, medical assistance and severe complications were assessed.
THE overall incidence of postoperative nasal bleeding throughout the observation period was similar between the two groups. The LMA reduced nasal bleeding in the OR. However, outside the OR, the incidence of the first episode of postoperative nasal bleeding in the LMA group was higher than that in the ETT group (difference: -26.5%; 95% CI: -42.2% to -10.7%; P < 0.001). In the LMA group, more patients needed medical assistance (P = 0.029), and the number of assistance was also higher (P = 0.027) in the ward. No severe complications occurred during the observation period.
The LMA does not alleviate nasal bleeding conditions and even increases the demands of medical service outside the OR after intranasal surgery, although it reduces epistaxis during extubation.
本研究旨在检测喉罩气道(LMA)与气管内插管(ETT)对鼻内手术后手术室(OR)内外术后鼻出血的影响。
134例行择期鼻内手术的患者在全身麻醉期间被随机分配接受LMA或ETT。在手术室和术后24小时内的病房评估鼻出血的发生率、发作次数和严重程度。此外,评估医疗援助和严重并发症。
在整个观察期内,两组术后鼻出血的总体发生率相似。LMA减少了手术室中的鼻出血。然而,在手术室之外,LMA组术后首次鼻出血的发生率高于ETT组(差异:-26.5%;95%CI:-42.2%至-10.7%;P<0.001)。在LMA组中,更多患者需要医疗援助(P=0.029),且病房中的援助次数也更高(P=0.027)。观察期内未发生严重并发症。
LMA并不能缓解鼻出血情况,甚至在鼻内手术后增加了手术室之外的医疗服务需求,尽管它减少了拔管期间的鼻出血。