Efficacy of four-way pipe fitting with laryngeal mask airway for airway management during tracheal stent implantation

Abstract

Objective To evaluate the efficacy of four-way pipe fitting with laryngeal mask airway(LMA) for airway management during tracheal stent implantation. Methods Thirty-six patients of both sexes, aged 18-64 yr, of American Society of Anesthesiology physical status Ⅱ or Ⅲ, scheduled for elective tracheal stent implantation, were allocated into 2 groups(n=18 each) using a random number table method: four-way pipe fitting with LMA group(FWP-LMA group) and rigid bronchoscope group. LMA was inserted after anesthesia induction, and the four-way pipe fitting and anesthesia machine were connected to perform intermittent positive pressure ventilation in FWP-LMA group. A rigid bronchoscope was implanted, and jet ventilator was used to assist ventilation in rigid bronchoscope group. The development of intraoperative hyoxemia, hypertension and tachycardia was recorded. Blood gas analysis was performed before operation and at the end of operation to record pH value, the partial pressure of arterial oxygen and partial pressure of arterial carbon dioxide. The success rate of tracheal stent implantation at first attempt and development of postoperative pharyngeal complications were also recorded. Results Operation was canceled due to rigid bronchoscope implantation in one patient in rigid bronchoscope group. Compared with rigid bronchoscope group, the pH value and partial pressure of arterial oxygen were significantly increased, and the partial pressure of arterial carbon dioxide was decreased at the end of operation, the incidence of intraoperative hyoxemia, hypertension and tachycardia was decreased, the incidence of postoperative sore throat and hoarseness was markedly decreased, operation time was prolonged, and the success rate of tracheal stent implantation at first attempt was decreased in FWP-LMA group(P<0.05). Conclusion The four-way pipe fitting with LMA produces better ventilation effect, induces slighter stress responses with fewer complications and can be safely used for airway management during tracheal stent implantation. Key words: Tracheal stenosis; Laryngeal masks; Four way pipe fitting