title: Use of the laryngeal mask airway in combination with regional anesthesia facilitates induction and emergence from general anesthesia in patients undergoing colorectal surgery.
abstract: The laryngeal mask airway (LMA) is selected as an alternative to the endotracheal tube (ETT) when rapid recovery from general anesthesia is considered. However, the clinical significance of this airway for abdominal surgery is unclear. Thus, we evaluated whether the LMA, in combination with regional anesthesia, facilitates the induction of and emergence from general anesthesia in patients undergoing elective colorectal surgery. Anesthesia-controlled time in a ETT/Epidural Anesthesia (EA) group [n = 11; general anesthesia, combined with epidural anesthesia, was maintained by sevoflurane (< 3%) supplemented with a fixed rate of propofol (3 mg/kg/h) under controlled ventilation using the ETT] was compared with that in a LMA/Combined Spinal-Epidural Anesthesia (CSEA) group [n = 10; in combination with spinal-epidural anesthesia, general anesthesia was maintained as the same protocol as the ETT/EA under spontaneous ventilation using the LMA]. Time for airway placement in the LMA/CSEA group was significantly shorter than that in the ETT/EA group. Intervals from the end of surgery until the removal of the airway or the decision to exit the operating room in the LMA/CSEA group were shorter than those in the ETT/EA group. No practical sign of aspiration pneumonia and/or atelectasis was found in patients in either group. Under the circumstance of regional anesthesia being requested for post-surgical pain management, we concluded that the LMA facilitated the emergence from as well as the induction of anesthesia without any practical complication when used for patients in colorectal surgery.
authors.affiliation: Department of Anesthesia, Hiroshima Red Cross & Atomic Bomb Survivors Hospital, Hiroshima 730-8619, Japan. azmacci@nifty.com
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Azma
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kawai
authors.forename: Motoichi
authors.initials: M
authors.lastname: Okida
authors.forename: Kuniko
authors.initials: K
authors.lastname: Okada
authors.forename: Hideki
authors.initials: H
authors.lastname: Tamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery