The Comparison Between Inhalation and Total Intravenous Anesthesia Effect on Voice With Supraglottic Airway Devices for Short-term Anesthesia

Abstract

Supraglottic airway devices (SADs) are a good alternative to endotracheal intubation (ETI) in short-term anesthesia applications since they have advantages including easy application, lower cost, enabling spontaneous ventilation. Total intravenous anesthesia (TIVA) and desflurane anesthesia allowing rapid recovery are anesthesia methods to be selected. Inhalation anesthesia by desflurane may cause adverse effects on airway mucosa and vocal cord functions. The aim of the present study was to compare the effect of the chosen anesthesia method on voice in gynecological patients who underwent short-term anesthesia with SADs. Seventy four patients whom short-term surgical procedure was planned in the Gynecology and Obstetrics Clinic were randomized into two groups for desflurane anesthesia (group D) and TIVA (group T). Voice recording was performed through larynx examination before anesthesia. Perioperative hemodynamic parameters, airway complications and postoperative airway complications were recorded. Laryngeal examination and voice recording were performed for the second time after 24 hours following the anesthesia procedure. Acoustic voice analysis of the patients was evaluated through the Praat program. The conditions including sore throat, dysphagia, and hoarseness were investigated after the anesthesia. Acoustic and aerodynamic properties of the voice, airway complications and pharyngolaryngeal complaints related to the use of SADs were compared in the patients. There was not any significant difference between the groups for demographic data. The SADs type and size have similar characteristics. No significant difference was detected between Group T and Group D for anesthesia duration (P=0.964). Both anesthesia methods cause similar effects on pharyngolaryngeal functions and voice. No significant difference was found between Group T and Group D in parameters other than the shimmer value of acoustic analysis. A statistically significant increase was observed in the Shimmer variable of group D (P < 0.05). When group T and group D were compared, there was not any significant difference in terms of airway complications, sore throat, dysphagia, and hoarseness. The TIVA and desflurane anesthesia presented similar clinical effects on voice and pharyngolaryngeal morbidity in the short-term gynecological operations through SADs. The increased shimmer value of acoustic voice analysis in Group D suggests that desflurane anesthesia may cause clinically insignificant deterioration on the voice. Further comprehensive studies are needed in order to demonstrate the effect of anesthetic agents on larynx functions in patients whom SADs is used.