Private Çankaya Hospital, Department of Anesthesiology and Reanimation, Ankara, Turkey.
University of Medical Science, Yıldırım Beyazıt Training and Research Hospital, Department of Anesthesiology and Reanimation, Ankara, Turkey.
Braz J Anesthesiol. 2022 May-Jun;72(3):359-364. doi: 10.1016/j.bjane.2021.12.004. Epub 2021 Dec 25.
This retrospective and observational study aimed to retrospectively evaluate the use of the endotracheal tube (ETT) and the Laryngeal Mask Airway (LMA) for the airway management with respect to airway safety, hemodynamic stability, adverse respiratory events, and recovery characteristics in patients who underwent endovascular treatment (EVT) for cerebrovascular arteriovenous malformation under general anesthesia between 2011 and 2018.
The study included data from the patient's electronic medical records and anesthesia files. The primary outcome measure was the incidence of hemodynamic disturbances and respiratory adverse events during airway management. The secondary outcome measure was the comparison of recovery characteristics.
The airway was secured using ETT in 41 patients and LMA in 39 patients. Airway safety was established in all patients without a complication throughout the procedure. Mean arterial blood pressure and heart rate were increased to > 20% of baseline levels at intubation and extubation periods in more patients in the ETT group than the LMA group (27 vs. 3; p = 0.07, and 11 vs. 2; p = 0.021). Respiratory adverse events including straining and coughing were observed in ten patients in the ETT group but only in one patient in the LMA group (p = 0.013). Time to extubation, to neurological assessment, and to discharge from the angiography unit were similar (p > 0.05).
It was concluded that LMA provided sufficient airway safety as with ETT and may be used as an alternative to ETT for EVTs under general anesthesia.
本回顾性观察研究旨在评估在 2011 年至 2018 年间全身麻醉下接受血管内治疗（EVT）的脑血管动静脉畸形患者中，使用气管内导管（ETT）和喉罩气道（LMA）进行气道管理时在气道安全性、血流动力学稳定性、呼吸不良事件和恢复特征方面的效果。
本研究纳入了患者电子病历和麻醉文件中的数据。主要结局指标为气道管理期间血流动力学紊乱和呼吸不良事件的发生率。次要结局指标为恢复特征的比较。
41 例患者使用 ETT ，39 例患者使用 LMA 来固定气道。所有患者在整个过程中均成功建立气道，无并发症。与 LMA 组相比，更多的 ETT 组患者在插管和拔管期间的平均动脉压和心率升高至基线水平的 20%以上（27 例比 3 例；p=0.07，11 例比 2 例；p=0.021）。在 ETT 组中有 10 例患者发生了呼吸不良事件，包括屏气和咳嗽，而在 LMA 组中只有 1 例患者发生了该事件（p=0.013）。拔管时间、神经评估时间和离开血管造影室的时间相似（p＞0.05）。
LMA 与 ETT 一样提供了充分的气道安全性，并且可以作为全身麻醉下 EVT 的 ETT 替代方法。
