The Advantages of Using Laryngeal Mask Airway in Case of Burn Eschar Excision Under General Anesthesia

Kim, Moo Hyun; Yoo, Jae Hong; Kim, Seung Soo; Ji, So Young

Abstract

PURPOSE
The most commonly used way of keeping airway, during general anesthesia, is endotracheal intubation. However, in case of short and simple surgery like escharectomy of burn wounds with Versajet(R), less invasive method using laryngeal mask airway is recommended rather than using endotracheal tube. The purpose of this study is to compare between laryngeal tube and endotracheal tube in case of escharectomy of burn wounds with Versajet(R), so that it may contribute to improving the ability of surgeon to carry out advanced airway management.
METHODS
We selected 60 patients undergoing general anesthesia 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 wounds less than 9% of body surface with Versajet(R) 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 endotracheal tube are both properly positioned and the ventilation efficient was not significantly different. We estimated the number of insertion attempts and the insertion time of endotracheal tube and laryngeal mask airway. Proper positioning, effect on cardiovascular system and postoperative airway 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 observed in incidences of Myalgia between the two groups. There is statistically significant difference in incidences of postoperative sore throat in the two groups (P-value= 0.0058). There is no statistically significant difference in incidences of postoperative nausea or vomiting in the two groups.
CONCLUSION
This comparative study suggests that Laryngeal mask airway (LMA) are useful for simple surgery of escharectomy of burn wounds with Versajet(R) and relatively more safer than using endotracheal tube (ETT) in general anesthesia for educated plastic surgeon in case of short and simple surgery like escharectomy of burn wounds.