Comparison of airway management without neuromuscular blockers in laparoscopic gynecological surgery.
Adult
Aged
Airway Management
/ instrumentation
Female
Gynecologic Surgical Procedures
/ methods
Head-Down Tilt
/ adverse effects
Humans
Intubation, Intratracheal
/ instrumentation
Laparoscopy
/ methods
Laryngeal Masks
/ statistics & numerical data
Middle Aged
Neuromuscular Blocking Agents
/ adverse effects
Pneumoperitoneum
/ epidemiology
Respiration
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
19 Feb 2021
19 Feb 2021
Historique:
received:
25
08
2020
accepted:
16
01
2021
entrez:
20
2
2021
pubmed:
21
2
2021
medline:
2
3
2021
Statut:
ppublish
Résumé
New generation supraglottic airway devices are suitable for airway management in many laparoscopic surgeries. In this study, we evaluated and compared the ventilation parameters of the laryngeal mask airway-supreme (LM-S) and endotracheal tube (ETT) when a neuromuscular blocker (NMB) agent was not used during laparoscopic gynecological surgery. The second outcome was based on the evaluation of the surgical view because it may affect the surgical procedure.This was a randomized study that enrolled 100 patients between 18 and 65 years old with an ASA I-II classification. Patients were divided into 2 groups: Group ETT and Group LM-S. Standard anesthesia and ventilation protocols were administered to patients in each group. Ventilation parameters [airway peak pressure (Ppeak), mean airway pressure (Pmean), total volume, and oropharyngeal leak pressure] were recorded before, after, and during peritoneal insufflation and before desufflation, as well as after the removal of the airway device. Perioperative surgical view quality and the adequacy of the pneumoperitoneum were also recorded.The data of 100 patients were included in the statistical analysis. The Ppeak values in Group ETT were significantly higher in the second minute after airway device insertion. The Ppeak and Pmean values in Group ETT were significantly higher before desufflation and after removal of the airway device. No significant differences were found between the groups in terms of adequacy of the pneumoperitoneum or quality of the surgical view.The results of this study showed that gynecological laparoscopies can be performed without using a NMB. Satisfactory conditions for ventilation and surgery can be achieved while sparing the use of muscle relaxants in both groups despite the Trendelenburg position and the pneumoperitoneum of the patients, which are typical for laparoscopic gynecological surgery. The results are of clinical significance because they show that the use of a muscle relaxant is unnecessary when supraglottic airways are used for these surgical procedures.
Identifiants
pubmed: 33607806
doi: 10.1097/MD.0000000000024676
pii: 00005792-202102190-00045
pmc: PMC7899844
doi:
Substances chimiques
Neuromuscular Blocking Agents
0
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
e24676Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
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