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2009, Number 1

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Rev Mex Anest 2009; 32 (1)

The usefulness of laryngeal masks when compared to endotracheal tubes in anesthesia for mastectomy

Sosa-Jaime NA, Pérez-Valverde SL, Rendón-Arroyo ME

Language: Spanish
References: 20
Page: 26-33
PDF size: 156.58 Kb.


ABSTRACT

Objective: We compared the usefulness of the laryngeal mask (LM) vs. the endotracheal tube (ET) for the management of the upper respiratory tract in patients subjected to mastectomy. Material and methods: It was studied a total amount of 207 patients subjected to modified radical mastectomy, with a physical condition ranging from ASA I to III. The patients were divided into two groups: Group I, LM, 104 patients and Group II, ET, 103 patients. Both groups were managed through general anesthesia balanced with sevoflurane, fentanyl, and vecuronium. The ventilation was kept by a semi-closed circuit with controlled mechanical ventilation. Results from the 104 patients of the Group I (LM): in 7 patients the placing of the LM was very difficult, and it was impossible in another one, due to escapes in ventilation. Therefore, it was necessary to practice tracheal intubation; the pharyngeal pain was present in the 10% of the patients. In the Group II (ET), with 103 patients, intubation was found difficult in 17 patients, and it was necessary to use fibrolaryngoscopy in 2 of the patients; pharynx pain was present in the 55% of the patients (p ‹ 0.05). In the ET placing, it was found an increase in cardiac frequency with a significant statistical difference (p ‹ 0.05). The medicine (drugs) consumption was lower for the ML Group with a significant statistical difference for vacuronium (p ‹ 0.05). Conclusion: The use of LM in patients subjected to mastectomy is safe and useful. It presents advantages over ET. We noticed a great usefulness in the use of LM in this kind of surgeries, where the complication possibility is reduced to a minimum and the patients go home with fewer problems in the upper respiratory tract.


REFERENCES

  1. Acosta VM, Ramírez AJ. Innovaciones en el manejo no invasivo de la vía aérea. Anestesia en México 1994;6:353-354.

  2. Mancha E, Torres J, Mackelligan P, Leos A, Salazar MR. Mascarilla laríngea en cirugía plástica ambulatoria, experiencia clínica en 100 casos. Anestesia en México 1994;5:287-290.

  3. Collins VJ. Concepts in anesthesiology. JAMA 1962;182:105.

  4. Henry Shuman. Journal of the history of medicine. Number anesthesia 1946.

  5. Brain AIJ. The laringeal mask. A new concept in airway management. Br J Anaesth 1983;55:801-805.

  6. Hath ML, Allagain J. The brain laringeal mask airway as an aid to intubation. Br J Anaesth 1990;64:382-383.

  7. Gursoy F, Algren JT, Skjonsby B. Positive pressure ventilation with the laryngeal mask airway in children. Anesth Analg 1996;82:33-38.

  8. Weiler N, Latorre F, Eberle B, Goedecke R, Heinrich W. Respiratory mechanics, gastric insufflation pressure, and air leakage of the laryngeal mask airway. Anesth Analg 1997;84:1025-1028.

  9. Sarma VJ. The use of laryngeal mask airway in spontaneously breathing patients. Acta Anaesthesiol Scand 1990;34:669-672.

  10. Verghese CH, Brimacombe JR. Survey of laringeal mask airway usage in 11,910 patients. Safety and efficacy for conventional and nonconventional usage. Anesth Analg 1996;82:129-133.

  11. Wakeling H, Butler PJ. Baxter P. The laryngeal mask airway: A comparison between two insertion techniques. Anesth Analg 1997;85:687-690.

  12. Bapat P, Joshi RN, Young E, Jago RH. Laryngeal mask insertion. Comparison of propofol and thiopental. World Congress af Anaesthesiologists. Sydney, Australia 1996, Abstract book D565, pag. 170.

  13. Brimacombe J, Berry A. The incidence of aspiration associated with the laryngeal mask airway-a meta-analysis of published literature. J Clin Anesth 1995;7:297-305.

  14. Green D, Ward B, Hughes N. Abscense of pressor response following early insertion of laringeal mask airway after induction with Propofol-fentanil. Br J Anaesth 1994;72: A54.

  15. Fujii Y, Tanaka H, Tokooka H. Circulatory responses to laryngeal mask airway insertion or tracheal intubation in normotensive and hypertensive patients. Can J Anaesth 1995;45:32-36.

  16. Keller C, Brimacombe J, Agro F, Margreiter J. A pilot study of pharyngeal pulse oximetry with the laryngeal mask airway. Anesth Analg 2000;90:440-444.

  17. Longan A. Use of laryngeal mask in a patients with unstable fracture of the cervical spine (letter). Anaesthesia 1991;46:987.

  18. Kihara S, Watanbe S, Brimacombe J, Taguchi N, Yamasaki Y. Segmental cervical spine movement with the intubating Laryngeal mask during manual in-line stabilization in patients with cervical pathology undergoing cervical spine surgery. Anesth Analg 2000;91:195-200.

  19. Patterson SJ, Byrne PJ, Molesky MG, et al. Neonatal resuscitation using the laryngeal mask airway. Anesthesiology 1994;80:1248-1253.

  20. Gandini D, Brimacombe J. Neonatal resuscitation with the laryngeal mask airway in normal and low birth weight infants. Anesth Analg 1999;89:642-3.




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