A Comparison Of Three Supremetm Laryngeal Mask Size Selection Method And The Influence To Postoperative Pharyngolaryngeal Problems

Objective:This study observe three method of SupremeTMlaryngeal mask sizeselection,compare the clinical effects and complications and side effects.To provide areference for clinical selection.Methods:A total of60patients under going selective operation under generalanesthesia were recruited in our hospital from November2012to April2013.Thepatients were20to66years old,ASA I-II,Mallampati I-II,with17.5-29.99kg/m2bodymass index.The subjects were randomly divided into three groups(A,B,C).Group Aselect laryngeal mask airway size by actual body weight(ABW).Group B select bystandard body weight(SBW).Group C select by sex.After inteavenous anesthesiainducion,an experienced user inserted the LMA SupremeTMwith the digitaltechnique.The cuff was inflated with air to an intracuff pressure of60cm H2O.Observelung inflations and auscultate the chest.If the thorax fluctuation is well,no obviousleakage,the SpO2is more than95%,fixed the LMA,begun to mechanicalventilation.Placing a lubricant in the proximal1cm of the drain tube and presssuprasternal notch.Inserted gastric tube into the drain tube.If the thorax fluctuation isnot well,or the suprasternal notch test is positive or insertion of gastric tube isunsuccessful,inserted the LMA again.And then tested the oropharyngeal leakpressure.The following were compared:ease of insertion,the insertiontime,oropharyngeal leak,ease of ventiation,gas exchange,location of gas leak,anatomicposition,mucosal injury,and postoperative pharyngolaryngeal problems.All theintraoperative and postoperative data collected respectively.Results:There were no statistical differences in age,sex,weight,height,body index,ASA classification，Mallampati score and other general condition (P>0.05).Therewere no statistical differences in ease of insertion,ease of ventiation,gasexchange,location of gas leak,anatomic position.The oropharyngeal leak pressure islower in groupA(p<0.05).Group B had a shorter insertion time (p<0.05).Group B had alower incidence of mucosal injury and postoperative pharyngolaryngealproblems(p<0.05).Conclusion: Size selection for the LMA SupremeTM is equally effective using themanufacturer’s weight-based formula or standard weight-based formula or thesex-based formula in healthy, anesthetized, adult patients,but standard weight-based ismore preferable,and had a lower incidence of mucosal injury and postoperativepharyngolaryneal problems.