Laryngeal mask airway use in otologic surgery

Abstract

Objective: The purpose of this study was to evaluate the safety and efficacy of the laryngeal mask airway (LMA) compared with oral endotracheal tube (ETT) in general anesthesia in patients who underwent otologic surgery.

Study design: Retrospective review.

Setting: Military tertiary care teaching hospital.

Patients: A retrospective chart review study was conducted on 484 patients who underwent otologic surgery at a large military tertiary care teaching hospital from January 2002 to August 2005. A review of otologic surgical cases using the LMA (n = 167) was compared to a similar cohort managed with an oral ETT (n = 317).

Main outcome measures: The patient's age, weight, indication for surgery, comorbid conditions, American Society of Anesthesiologists classification, duration of surgery, and adverse events were recorded. Specific data reviewed included airway complications, intraoperative times, anesthetic medications, postoperative nausea and vomiting, and time spent in the postanesthesia care unit.

Results: There were no major airway complications in either group requiring an emergency airway. A significant decreased use of neuromuscular blocking agents was noted in the LMA group. Statistical analysis of variances was performed using 2-sample Wilcoxon rank-sum (Mann-Whitney U) test and Fisher's exact test. The time in the operating room to the start of surgery and the time from completion of surgery to patient exiting the operating room were shorter for the LMA group than for the ETT group. There were no statistical differences in postanesthesia care unit time or postoperative nausea and vomiting.

Conclusion: The LMA offers a safe alternative in children and adults to endotracheal intubation with no observed increased risk of airway complications in patients undergoing otologic surgery.