Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun;10(6):3216-3224.
doi: 10.21037/jtd.2018.05.74.

A comparison between laryngeal mask airway and endotracheal intubation for anaesthesia in adult patients undergoing NUSS procedure

Songsong Mao  1 , Xiaojun Du  2 , Jue Ma  1 , Guangyan Zhang  1 , Jianxiu Cui  1
Affiliations

A comparison between laryngeal mask airway and endotracheal intubation for anaesthesia in adult patients undergoing NUSS procedure

Songsong Mao et al. J Thorac Dis. 2018 Jun.

Abstract

Background: This study evaluates and compares the feasibility and safety of application of laryngeal mask airway (LMA) and endotracheal intubation (ETT) for anaesthesia in adult patients undergoing thoracoscopic surgery.

Methods: Sixty adult patients with pectus excavatum (PE) undergoing video-assisted thoracoscopic surgery for the NUSS procedure (VATS-NUSS) between September 2016 and March 2017 were selected and randomly separated into two groups with different methods of airway management. In one group, LMA was applied for general anaesthesia, and in the other group, ETT was used. The clinical parameters before, during and after the surgery in patients from both groups were collected from multiple data resources in a hospital. SPSS software was used for the analysis.

Results: Of all the selected patients, the physiological parameters showed similarity between the LMA and ETT groups, indicating consistency in the clinical characteristics of the study sample. Additionally, no significant differences were discovered between the two groups in terms of the anaesthesia and surgical time, peak PetCO2 during operation, anaesthetic satisfaction score, and amount of blood loss as well as inpatient time for recovery. However, with a similar level of anaesthesia effects and suitable parameters for mechanical ventilation, patients in the LMA group showed much more stability in the physiological indicators for inflammation and haemodynamics, including white blood cell count (ΔWBC) and percentage of neutrophil granulocytes (ΔNEU%) in the blood as well as heart rate (ΔHR) and mean arterial pressure (ΔMAP). Moreover, the LMA patients had a significantly shorter time for recovery of consciousness and food/water intake. Finally, compared to the ETT group, patients in the LMA group also had a significantly lower incidence of side effects induced by the anaesthesia procedure after surgery, such as gastrointestinal reactions, throat discomfort and hoarseness.

Conclusions: Compared with ETT, the application of LMA for general anaesthesia may demonstrate promising advantages in airway management for the VATS-NUSS procedure.

Keywords: Laryngeal mask airway (LMA); NUSS; adult patients; endotracheal intubation (ETT).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

References

    1. Nuss D, Kelly RE, Croitoru DP, et al. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg 1998;33:545-52. 10.1016/S0022-3468(98)90314-1 - DOI - PubMed
    1. Nuss D, Kelly RE. The Minimally Invasive Repair of Pectus Excavatum. Oper Tech Thorac Cardiovasc Surg 2014;19:324-47. 10.1053/j.optechstcvs.2014.10.003 - DOI
    1. Futagawa K, Suwa I, Okuda T, et al. Anesthetic management for the minimally invasive Nuss procedure in 21 patients with pectus excavatum. J Anesth 2006;20:48-50. 10.1007/s00540-005-0367-4 - DOI - PubMed
    1. Mavi J, Moore DL. Anesthesia and analgesia for pectus excavatum surgery. Anesthesiol Clin 2014;32:175-84. 10.1016/j.anclin.2013.10.006 - DOI - PubMed
    1. Koumbourlis AC. Pectus excavatum: pathophysiology and clinical characteristics. Paediatr Respir Rev 2009;10:3-6. 10.1016/j.prrv.2008.12.002 - DOI - PubMed

LinkOut - more resources