Laryngeal mask airway versus endotracheal tube for outpatient surgery: analysis of anesthesia-controlled time.
OBJECTIVE
To show that efficiency of operating room times can be improved significantly using rapid changes between operative procedures.


METHODS
Randomized, prospective clinical study.


METHODS
Tertiary care university hospital, elective peripheral trauma-related orthopedic surgery.


METHODS
72 adult, ASA physical status I, II, and III patients scheduled for elective peripheral trauma-related orthopedic surgery requiring general anesthesia.


METHODS
Patient airways were managed using either a Laryngeal Mask Airway (LMA) or an endotracheal tube (ETT) in the hands of anesthesiologists experienced in both. They were not informed as to the primary intention of the study. All perioperative data, including the preoperative and postoperative outpatient stay at the outpatient surgical ward, were recorded with an anesthesia information management system.


METHODS
The primary outcome measures were: time needed for anesthesia induction and emergence from anesthesia. All manual recording into the anesthesia information management system during anesthesia was accomplished by nurses who were uninformed as to the aim of the study.


RESULTS
Anesthesia induction was significantly (p < 0.01) shorter using LMAs (means +/- SD, medians, [interquartile ranges]) (LMA: 5.8 +/- 1.5, 5, [5;7] vs. ETT: 7.4 +/- 1.8, 7, [7;8] min), whereas emergence from anesthesia was not different (LMA: 11.8 +/- 3.3, 11, [9;14] vs. ETT: 13.2 +/- 4.8; 12, [10;16] min).


CONCLUSIONS
The clinical relevance of reduced anesthesia induction time using LMA is questionable. The lack of difference in emergence time could be a result of the use of total intravenous anesthesia.
Hartmann
Bernd
B
Department of Anesthesiology, Intensive Care, and Pain Therapy, University Hospital, Giessen, Germany.
Banzhaf
Anne
A
Junger
Axel
A
Röhrig
Rainer
R
Benson
Matthias
M
Schürg
Rainer
R
Hempelmann
Gunter
G
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000379:methods*; D000771:Anesthesia, Intravenous / Q000379:methods; D004305:Dose-Response Relationship, Drug; D005260:Female; D005858:Germany; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods* / Q000706:statistics & numerical data*; D007546:Isoquinolines / Q000627:therapeutic use; D017214:Laryngeal Masks / Q000706:statistics & numerical data*; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data; D000077590:Mivacurium; D003473:Neuromuscular Nondepolarizing Agents / Q000627:therapeutic use; D019637:Orthopedic Procedures / Q000379:methods; D010880:Piperidines / Q000627:therapeutic use; D015742:Propofol / Q000627:therapeutic use; D011446:Prospective Studies; D000077208:Remifentanil; D013997:Time Factors; D016896:Treatment Outcome
D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D000077590:Mivacurium; D000077208:Remifentanil; D015742:Propofol