The usefulness of the laryngeal mask airway Fastrach for laryngeal surgery.
OBJECTIVE
Suspension laryngoscopy under general anaesthesia with a tracheal tube has been widely used for laryngeal microsurgery, but it has some limitations such as intense cardiovascular stimulation during anaesthesia of short duration, occasionally a poor surgical field, and the possibility of a mass being hampered by the tracheal tube. The aim of this study was to compare the usefulness of the laryngeal mask airway (LMA) Fastrach and fibreoptic bronchoscope with a conventional suspension laryngoscope in laryngeal microsurgery.


METHODS
Forty patients scheduled for laryngeal microsurgery were enrolled in this prospective randomized study consecutively. After general anaesthesia was induced, laryngeal microsurgery was performed with a fibreoptic bronchoscope through the LMA Fastrach or conventional suspension laryngoscope. The best view of the surgical field, evaluated by percentage of glottic opening score, was obtained by the up-down manipulations of the LMA Fastrach or repositioning the suspension laryngoscope. Blood pressure and heart rate changes at the baseline, preinsertion, and postinsertion were recorded.


RESULTS
Percentage of glottic opening score of the LMA Fastrach group was 100 and that of the suspension laryngoscope group was 80 (P < 0.05). The LMA Fastrach insertion was performed without remarkable systolic or diastolic blood pressure or heart rate changes, but systolic, diastolic blood pressure or heart rate were increased after intubation in the suspension laryngoscope group.


CONCLUSIONS
The LMA Fastrach during fibreoptic bronchoscope-guided laryngeal surgery provided a good surgical field and haemodynamic stability without additional risk compared with the conventional suspension laryngoscope.
Chang
Chul Ho
CH
Department of Anaesthesiology and Pain Medicine and Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Bai
Sun Joon
SJ
Kim
Mi Kyeong
MK
Nam
Sang Beom
SB
D000328:Adult; D000768:Anesthesia, General / Q000295:instrumentation* / Q000379:methods; D001794:Blood Pressure; D001999:Bronchoscopy / Q000379:methods; D005260:Female; D005336:Fiber Optic Technology; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D017214:Laryngeal Masks; D007830:Larynx / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011446:Prospective Studies