Efficacy Of Flexible Laryngeal Mask Forairway Management In Pediatric Tonsillectomy

ObjectiveTo evaluate the safety and effectiveness of flexible laryngeal mask airway in pediatric tonsillectomy.MethodsThirty children of American Society of Anesthesiologists(ASA)I~II stage,aged 2~10 years old,weighed 10 kg~50 kg,scheduled for selective tonsillectomy surgery,were equally randomized into two groups: flexible laryngeal mask airway group and tracheal intubation group,and each group contained 15 cases.Anesthesia induction: for two groups,midazolam 0.1 mg/kg,propofol 3 mg/kg,sufentanil 0.5?g/kg;and added cis-atracurium 0.15mg/kg for tracheal intubation group.Anesthesia maintaince with continuous infusion of remifentanil 6~10mg/(kg·h)and propofol 0.2~0.5ug/(kg·min)for two groups.The values of HR,BP in two groups were recorded at different times: before anesthesia induction(t1),after anesthesia induction(t2),inserting the laryngeal mask airway or endotracheal intubation(t3),placing speculum oris(t4),the ending of the operation(t5),and immediately extubation(t6).Collecting blood specimen and detecting plasma concentrations of glucose and cortisol at before anesthesia induction(T1)inserting the laryngeal mask airway or endotracheal intubation(T2),placing speculum oris(T3),immediately extubation(T4);The dosage of anesthetic,liquid intake and output,anesthesia time,spontaneous breathing recovery time,extubation time and consciousness time were recorded.In addition,the success rate of first insertion and total insertion,complications such as emergence agitation,bloating,bucking,laryngeal spasm during the recovery of anesthesia were investigated.ResultsCompared with tracheal intubation group,in flexible laryngeal airway mask group the spontaneous breathing recovery time,extubation time,consciousness time was obviously shortened(P< 0.05);The HR,MAP at t3 and t6 in tracheal intubation group was significantly higher than flexible laryngeal mask airway group(P < 0.05);The comparison of blood glucose and cortisol concentration at different time point between two groups has no statistical significance.The incidence of bucking was obviously lower in flexible laryngeal mask airway group(P<0.05).ConclusionThe application of flexible laryngeal mask airway in pediatric tonsillectomy has less stress reaction,low incidence of complications and perfectly safety and effectiveness.It is worth popularization and application in clinic.