Observations on the application of LMA in the airway management in total laparoscopic hysterectomy in obese patients

Abstract

Objective To observe the curative effects of applying laryngeal masks in the airway management in total laparoscopic hysterectomy in obese patients. Methods 60 cases of obese patients who underwent total laparoscopic hysterectomy were collected and were randomly divided into, the Endotracheal intubation(ET)group(n=30) and the laryngeal mask(LMA)group(n=30). The pre-operative co-existent diseases, applications of analgesia and intra-operative vital signs, the peak airway waves(Paw)60min after pneumoperitoneum,blood gas;revival time; the incidences of complications were observed. Results 60min after pneumoperitoneum,MAP,HR, Paw and Sp O 2 values were:ET group:[(114.6±22.4)mm Hg,(108.2±19.6)times/min,(25.4±3.1)mm Hg, (96.1±1.2%)]LMA group:[(97.5±20.8)mm Hg,(86.5±20.7)times/min,(22.6±3.7)mm Hg,(98.9±0.8%)].The difference was statistically significant(P<0.05);The blood gas analysis,PH,PaO2,PaCO2 and BE values are:ET group:[(7.34±0.05),(177.5±44.5)mm Hg,(42.6±6.1)mm Hg,(-4.9±0.8)mmol/L],LMA group:[(7.38±0.05),(216.7±46.6)mm Hg,(38.4±5.5)mm Hg,(-3.1±0.6)mmol/L].The difference was statistically significant(P<0.05);the status of complications:23 cases in ET group,accounting for 77%,10 cases in LMA group,accounting 30%,presenting significant differences(P<0.05). Conclusion The application of laryngeal masks in the airway management in total laparoscopic hysterectomy in obese patients facilitated the maintaining the stability of hemodynamics and blood gas, resulted in smooth post-anesthesia recovery and fewer complications. Key words: Hysterectomy; Laparoscopy; Obesity; Laryngeal mask anesthesia, surface