Dumas George A, Bryant Ayesha S, Ibey Justin, Long John A, Vicinanzo Matthew G, Boyd Gwendolyn L
Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham.
Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A.
Ophthalmic Plast Reconstr Surg. 2018 Jul/Aug;34(4):324-328. doi: 10.1097/IOP.0000000000000969.
This study will determine the safety of laryngeal mask airway (LMA) compared with endotracheal tube (ETT) in patients undergoing general anesthesia for dacryocystorhinostomy (DCR) surgery.
In this retrospective cohort study, intraoperative and postoperative outcomes of patients who underwent DCR at UAB Callahan Eye Hospital using either LMA or ETT were compared.
Over a period of 52 months, 429 patients underwent external DCR surgery. An ETT was used in 37 patients and LMA in 392 patients. Baseline patient characteristics and anesthetic management were similar. No documented cases of blood or gastric aspiration occurred in the total cohort. Our study confirmed the findings of others that there is less cardiovascular lability on LMA placement than with ETT intubation. A 30% increase in heart rate from baseline after intubation (ETT 10.8%, LMA 1.8%; p = 0.010) and after incision (ETT 8.1%, LMA 1.8%; p = 0.047) occurred more frequently in the ETT group. Airway management with an LMA was also less difficult compared with an ETT (ETT 5.7%, LMA 0.5%; p = 0.035).
The use of an LMA for airway control is safe and effective in patients undergoing general anesthesia for DCR surgery. No events of aspiration occurred with LMA use. Heart rate increase was significantly less in the LMA group. In our opinion, use of an LMA for airway control during DCR surgery is superior to use of an ETT. Airway protection, improved hemodynamics, and less difficulty in placement of the laryngeal airway device are all validated by this study.
本研究将确定在接受泪囊鼻腔吻合术（DCR）全身麻醉的患者中，喉罩气道（LMA）与气管内插管（ETT）相比的安全性。
在这项回顾性队列研究中，比较了在UAB卡拉汉眼科医院使用LMA或ETT进行DCR手术的患者的术中及术后结果。
在52个月的时间里，429例患者接受了外路DCR手术。37例患者使用了ETT，392例患者使用了LMA。患者的基线特征和麻醉管理相似。整个队列中未记录到血液或胃内容物误吸的病例。我们的研究证实了其他人的发现，即与ETT插管相比，放置LMA时心血管稳定性更高。插管后（ETT组为10.8%，LMA组为1.8%；p = 0.010）和切口后（ETT组为8.1%，LMA组为1.8%；p = 0.047）心率较基线增加30%的情况在ETT组中更频繁发生。与ETT相比，使用LMA进行气道管理也更轻松（ETT组为5.7%，LMA组为0.5%；p = 0.035）。
在接受DCR手术全身麻醉的患者中，使用LMA进行气道控制是安全有效的。使用LMA未发生误吸事件。LMA组心率增加明显更少。我们认为，在DCR手术期间使用LMA进行气道控制优于使用ETT。本研究证实了LMA在气道保护、改善血流动力学及放置难度较低等方面的优势。
