title: Prospective randomized controlled trial on the use of flexible reinforced laryngeal mask airway (LMA) during total thyroidectomy: effects on postoperative laryngopharyngeal symptoms.
abstract: BACKGROUND
  Sore throat, hoarseness, dysphagia, and cough are common laryngopharyngeal discomforts after thyroidectomy. The incidence and severity of laryngopharyngeal symptoms after the use of a flexible reinforced laryngeal mask airway (LMA) were compared with those that occur after the use of a plain endotracheal tube in patients after thyroidectomy.
  
  
  METHODS
  Seventy-six patients scheduled for total thyroidectomy were randomized into a plain endotracheal tube group (group E) or a flexible reinforced LMA group (group L). Total intravenous anesthesia (propofol and remifentanil) was used for maintenance of anesthesia. Hemodynamic variables were recorded during induction of anesthesia. The incidence and severity (100-point numerical rating scales) of laryngopharyngeal symptoms, including sore throat, hoarseness, dysphagia, and cough, were assessed at 1, 24, and 48 h after surgery.
  
  
  RESULTS
  All patients were placed successfully with an endotracheal tube or a flexible reinforced LMA. The postoperative incidence and severity of sore throat (25 vs. 33 at 24 h, p = 0.035, 17 vs. 28 at 48 h, p = 0.017; 50 [0-100] vs. 80 [20-100] at 1 h, p = 0.002; 30 [0-80] vs. 50 [0-100] at 24 h, p < 0.001; 0 [0-40] vs. 30 [0-90] at 48 h, p < 0.001) and hoarseness were lower in group L than in group E. At 48 h postoperatively, dysphagia (p = 0.005) and cough (p = 0.028) occurred less frequently in group L than in group E patients.
  
  
  CONCLUSIONS
  A flexible reinforced LMA placed during surgery decreases the incidence and severity of laryngopharyngeal symptoms and is a feasible anesthetic tool compared with a conventional endotracheal tube for thyroidectomy.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea, jinaryu@lycos.co.kr.
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Ryu
authors.forename: Cha Kyong
authors.initials: CK
authors.lastname: Yom
authors.forename: Cha-Kyoung
authors.initials: CK
authors.lastname: Yom
authors.forename: Do-Joong
authors.initials: DJ
authors.lastname: Park
authors.forename: Kyu-Hyung
authors.initials: KH
authors.lastname: Kim
authors.forename: Sang-Hwan
authors.initials: SH
authors.lastname: Do
authors.forename: Seok-Ha
authors.initials: SH
authors.lastname: Yoo
authors.forename: Ah-Young
authors.initials: AY
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D013965:Thyroidectomy; D055815:Young Adult