The effect of laryngeal mask versus that of endotracheal tube on stress response in children age 1 to 3 during surgery with general anesthesia

Abstract

Objective To compare the effect of laryngeal mask with that of endotracheal tube on stress response in children age 1 to 3 during surgery with general anesthesia.Methods 100 children age 1 to 3 who received selective laparoscopic hernia sac high ligation were randomly divided into group A ( laryngeal mask )and group B( endotracheal tube ).In both groups,7％ sevoflurane,fentanyl,vecuronium bromine amine,and propofol were used for induction of general anesthesia.Laryngeal mask was placed in group A while endotracheal tube was used in group B.Changes in MBP and HR and plasma cortisol levels were observed and recorded efore induction ( T0 ),immediately after inserting a laryngeal mask or endotracheal tube ( T1 ),2 minutes later ( T2 ),5 minutes later ( T3 ),and immediately after removing the laryngeal mask or endotracheal tube ( T4 ).The SPSS 13.0 software was used for statistical analysis.Results The changes in MBP and HR did not differ in group A between T0 and T1,T2,T3,and T4 ( P ＜ 0.05 ); MBP and HR were markedly elevated at T1 and T2 in group B as compared with those at T0 and were slightly lower at T3 but were stil higher than those at T0,the difference being sgnificant ( P＜ 0.05 ).There were no significant differences in MBP and HR at T0 btween group A and group B; while at the other time points,MBP and HR were markedly higher than in group B than in group A ( P ＜ 0.05 ).Plasma cortisol levels did not differ significantly in group A between T0 and T1,T2,T3,and T4 ( P ＞ 0.05 );in group B,the levels of plasma cortisol at T 1,T2,T3,and T4 were significantly higher than those at T0( P ＜ 0.05 ).There were no significant differences in cortisol levels btween group A and group B at T0;while at the other time points,cortisol levels were higher in group B than in group A ( P ＜ 0.05 ).Conclusions Laryngeal mask causes less stress response induced by general anesthesia than endotracheal tube does in children age 1 to 3. Key words: Laryngeal mask; Endotracheal tube; Children; General anesthesia; Stress response