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Comparison of airway management without neuromuscular blockers in laparoscopic gynecological surgery
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 u...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899844/ https://www.ncbi.nlm.nih.gov/pubmed/33607806 http://dx.doi.org/10.1097/MD.0000000000024676 |
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author | Ozbilgin, Sule Kuvaki, Bahar Şimşek, Hatice Keskin Saatli, Bahadir |
author_facet | Ozbilgin, Sule Kuvaki, Bahar Şimşek, Hatice Keskin Saatli, Bahadir |
author_sort | Ozbilgin, Sule |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7899844 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-78998442021-02-24 Comparison of airway management without neuromuscular blockers in laparoscopic gynecological surgery Ozbilgin, Sule Kuvaki, Bahar Şimşek, Hatice Keskin Saatli, Bahadir Medicine (Baltimore) 3300 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. Lippincott Williams & Wilkins 2021-02-19 /pmc/articles/PMC7899844/ /pubmed/33607806 http://dx.doi.org/10.1097/MD.0000000000024676 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | 3300 Ozbilgin, Sule Kuvaki, Bahar Şimşek, Hatice Keskin Saatli, Bahadir Comparison of airway management without neuromuscular blockers in laparoscopic gynecological surgery |
title | Comparison of airway management without neuromuscular blockers in laparoscopic gynecological surgery |
title_full | Comparison of airway management without neuromuscular blockers in laparoscopic gynecological surgery |
title_fullStr | Comparison of airway management without neuromuscular blockers in laparoscopic gynecological surgery |
title_full_unstemmed | Comparison of airway management without neuromuscular blockers in laparoscopic gynecological surgery |
title_short | Comparison of airway management without neuromuscular blockers in laparoscopic gynecological surgery |
title_sort | comparison of airway management without neuromuscular blockers in laparoscopic gynecological surgery |
topic | 3300 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899844/ https://www.ncbi.nlm.nih.gov/pubmed/33607806 http://dx.doi.org/10.1097/MD.0000000000024676 |
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