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KMID : 0853020140170020086
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Journal of Korean Burn Society
2014 Volume.17 No. 2 p.86 ~ p.90
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The Advantages of Using Laryngeal Mask Airway in Case of Burn Eschar Excision Under General Anesthesia
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Kim Moo-Hyun
Yoo Jae-Hong
Kim Seung-Soo
Ji So-Young
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Abstract
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Purpose: The most commonly used way of keeping airway, during general anesthesia, is endotracheal intubation. How-ever, in case of short and simple surgery like escharectomy of burn wounds with Versajetⓡ, less invasive method using laryngeal mask airway is recommended rather than using en-dotracheal tube. The purpose of this study is to compare be-tween laryngeal tube and endotracheal tube in case of es-charectomy of burn wounds withVersajetⓡ, so that it may contribute to improving the ability of surgeon to carry out ad-vanced airway management.
Methods: We selected 60 patients undergoing general anes-thesia randomly who were to be given short operation lasting less than one hour and then anestheize each 30 patients by using endotracheal tube and laryngeal mask airway. Patients who underwent escharectomy of deep secondary burn woun-ds less than 9% of body surface with Versajetⓡ were also divided into two groups (laryngeal mask airway, LMA group: 30 people, endotracheal tube, ETT group: 30 people). The size of laryngeal tube and laryngeal mask airway is chosen by body weight and sex. The laryngeal mask airway and en-dotracheal tube are both properly positioned and the ven-tilation efficient was not significantly different. We estimated the number of insertion attempts and the insertion time of en-dotracheal tube and laryngeal mask airway. Proper position-ing, effect on cardiovascular system and postoperative air-way problems (sore throat, nausea) after the recovery were also recorded. Successful insertion was judged by the Anesthesiologist.
Results: Probability of success rate were higher in the LMA group than in the ETT group in the first attempt (P-value= 0.028). Time used in successful insertion in the first attempt with LMA insertion group was significantly shorter than ETT insertion group (P-value= 0.014). Mean dosage of the muscle relaxants used were higher in the ETT group than in the LMA group (P-value= 0.012). No significant differences were ob-served in incidences of Myalgia between the two groups. Th-ere is statistically significant difference in incidences of posto-perative sore throat in the two groups (P-value= 0.0058). The-re is no statistically significant difference in incidences of po-stoperative nausea or vomiting in the two groups.
Conclusion: This comparative study suggests that Laryngeal mask airway (LMA) are useful for simple surgery of eschar-ectomy of burn wounds with Versajetⓡ and relatively more safer than using endotracheal tube (ETT) in general anes-thesia for educated plastic surgeon in case of short and sim-ple surgery like escharectomy of burn wounds
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KEYWORD
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Laryngeal mask, Laryngeal mask airway, Intra-tracheal intubation
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