1 *MD, JBO department of anesthesiology and intensive care, Royal Jordanian Medical Services
2 #MD, JBENT, Department of ENT, Royal Jordanian Medical Services, Prince Hashem Hospital.
The purpose of the study was to compare the suitability and safety of the laryngeal mask airway (LMA), for intranasal surgery (INS) anesthesia, with endotracheal tube (ET) anesthesia.
we studied 65 patients (ASA grade I and II, according to American Society of Anesthesia classification), aged (18-39) years. The study population was scheduled for elective intranasal surgery. The patients were randomly assigned into two groups: the first group (33 patients), a laryngeal mask airway (LMA Group) was inserted under propofol , fentanyl and muscle relaxant (atracrium), anesthesia was maintained by using a mixture of halothane in N2O/O2. The second Group (32 patients), an endotracheal tube (ET Group) was inserted under propofol, fentanyl and muscle relaxant (atracrium), anesthesia was maintained with a mixture of halothane in N2O/O2.
All complications concerning airway insertion, removal or interruption of surgery for compromised airway and ventilation were recorded. Mean blood pressure, heart rate and pulse oxymetry, were continuously monitored and recorded before and after induction and airway device insertion, followed by 10 minutes intervals. Data were analyzed using chi square statistical test; Null hypothesis was rejected at P> 0.05.
In LMA Group, there were no episodes of post removal laryngospasm. The incidence of oxyhemoglobine desaturation at removal was significantly reduced compared with that in ET Group (P< O.O2). The number of patients with oxyhemoglobine desaturation less than 92% on airway device removal was 0% in LMA Group, 3 patients (9.375%) in ET Group.
In ET Group, the mean blood pressure and heart rate showed significant variation between the different time measurements (P> 0.005). Intubation and extubation resulted in significant transient increase in mean blood pressure and heart rate. In LMA Group, the mean blood pressure was less than baseline value from 1 minute after induction onwards (P< 0.005) and did not show any significant changes during the different time points measurements. LMA application or removal did not cause any significant increase in mean blood pressure or heart rate (P< 0.001).
We conclude that using LMA is suitable method for intranasal surgery. It provides a safe, protected airway with a smoother emergence from anesthesia than tracheal intubations. Anesthesia using LMA for intranasal surgery provides a stable circulation.