The Clinical Application Of Flexible Laryngeal Mask Airway In Low-temperature Plasma Adenotonsillectomy

Objective:Observe the Efficacy of flexible laryngeal mask airway inLow-temperature Plasma Adenotonsillectomy.Method:43patients have no contraindications, ASA I-II,3-6years old.The patients are randomly divided into two groups, flexible laryngeal maskairway group （F group） and endotracheal intubation group （T group）. There are20cases in F group,and23cases in T group. Preoperative tests and chemicalexamination are normol. After entering operating room, monitoring of ECG, BP,SpO₂, HR are carried out on the patients, Midazolam0.04mg·kg^-1, fentanyl1-2ug·kg^-1,propofol2-4mg·kg^-1, cis-Atracurium0.1mg·kg^-1, dexamethasone0.1-0.2mg·kg^-1, ondansetron0.1mg·kg^-1, penehyclidine0.01mg·kg^-1areadopted in anesthesia induction. FLMA was inserted when the patients lostconsciousness. Mechanical ventilated were completed, maintained PETCO₂35-45mmHg. Anesthesia was maintained with propofol4^-12·kg^-1·h^-1andremifentanil6^-18μg·kg^-1·h^-1. BP （blood pressure） and HR （heart rate） weremaintained normally. Atropine is given when HR is lower than80times perminute. The rate of successful placement, complication, anesthesia time,duration of surgery, recovery time, dosage of propofol and remifentanil during the operation. SBP, DBP, MAP, HR were recorded before induction ofanesthesia （T₀）, before insertion of Tracheal tube or FLMA （T₁）, after insertionat1min （T₂）,3min （T3）, gag placement （T₄）, and before removal of Trachealtube or FLMA （T₅）, after removal （T₆）. Ppeak, PetCO₂and SpO₂were recordedafter insertion of Tracheal tube or FLMA immediately （T₇）, at5min （T₈）,15min （T₉）,30min (T₁₀), and45min （T11）, gag placement （T₄）, before removal oftracheal tube or FLMA （T₅）. When the patients open their eyes, unplug theFLMA, and give oxygen3L·min^-1under mask airway. Statistical treatment iscompleted with SPSS19.0package. Measurement data is expressed by mean （x）±standard deviation（S）, T test was used within two groups. The statistic methodwas respectively adopted the matched T test and of measurement data andFisher’s exact test to analyse by using SPSS19.0statistic software.Measurement data is expressed by mean （x）±standard deviation （S）, P<0.05isconsidered as statistical significance.Result:1.The rate of the first successful placement was90%、100%respectively, the difference was statistically significant.P<0.05. And the rate ofplacement was100%.2. the placement time of F group was shorter than T group,the difference was statistically significant.P<0.05.3. In tracheal tube group，SBP，HR at T2、T4were significantly higher than that at T1（P<0.05） and SBP,HR at T6were higher than that at T₅（P<0.05）. SBP, HR at T2, T6SBP, HR intracheal tube group were significantly higher that at T2、T6in FLMA group. SBP,DBP, MAP, HR had no significantly change in FLMA group.4. SpO₂, Ppeak, PetCO₂in every group and between two groups had no significantly change.complication between two groups have no statistical significance.5. The rate ofcoughing in tracheal tube group were higher than that in FLMA group （P<0.05）.6. The dosage of propofol and remifentanil during the operation in tracheal tubegroup is more than that in FLMA group, but had no significantly changebetween two groups （P>0.05）.Conclusion:1. The use of FLMA in Adenotonsillectomy surgery can makehemodynamic more stable, ventilation good, and fewer perioperativecomplications. Flexible laryngeal mask airway were safe and effective forAdenotonsillectomy.