Laryngeal mask and endotracheal tube: Comparison of postoperative comfort by patientʼs self evaluation: 19AP3–8

Background and Goal of Study: Patient’s satisfaction is one of the rel- evant and important indicator in evaluating quality of medical care in general. Endotracheal tube (ETT) and LMA classic are both effective, realible and safe; intubation is old gold standard,more safe but more agressive and LMA classic is relativly new,with limited indications,less safe and less agressive. Postoperative comfor,releted to laryngopharyngeal morbidity is still not exactly defined for each devices of airway menagement beacause of dificulty in measuring it. Materials and Methods: We compare postoperative comfor and laryngoharyngeal morbidity by patient’s self evaluation, using ‘‘face to face’’ and ‘‘self- releted’’ ques- tionaire on 4h and 24h after surgery, investigating general satisfaction, sore throat, difficulty of swallowing and hoarsness. The study is clinical,prospective,randomised and single blinde, with only one, experiensed, anestesiologist to perform anethesia and to be investigator. Seventy patients divided in two groups by LMA and ETT, ASA physical status class I or II, aged 18-60 yr, Mallampati I or II, no smokers, BMI < 30 kg/m2 undergoing elective abdominal, gynegological and orthopedic surgery, and urological endoscopic interventions, lasting one hour. Results and Discussion: Groups were homogen by few caracteristics pos- sible to influent postoperative discomfor: sex, age, number of insertion attempts and educational level releted to understanding and way of ansering questions. General feelings of satisfaction: 17 patients decler exellent in LMA group and only 8 in ETT group. There were no hoarsness in LMA groupe, only two patients in ETT group after 4h. Sore throath was presented by six patients in LMA groupe, comparing to 12 patients in ETT groupe after 4h. After 24 hours in each group were 10 patients with above mentioned simptom. In LMA groupe dysphagia had 2 patients and 5 in ETT groupe after 4h. After 24h there were 6 patients in LMA groupe,without any in ETT groupe. Conclusion(s): There were no significant differences regarding postoperative comfor between anesthesia with the LMA or intubation on the day of surgery and first postoperative day. Also, there were no specific laringofaryngeal mor- bidity model folowing LMA insertion comparing the intubation. peculiarities. Intubation in the lateral position is more difficult than in supine position. The use of the supraglottic airway devices allows a new approach for these situations. The aim of our study is to evaluate the difficulty of insertion of the supraglottic airway device i-gel in the lateral position. Materials and Methods: We included ASA I-II patients without predicted difficult airway undergoing scheduled surgery with general anesthesia. We divided them in two groups, those in whom surgery was performed in the supine position and a second group of the lateral (right and left) position. Anaesthesia was induced with the patient already in the chosen position for the surgical procedure. Both groups were monitored with a non invasive standard monitoring, and after three minutes of preoxigenation, we started the anaesthetic induction with fentanil, propofol and rocuronium. After the confirmation of suitable neuromuscular blockade by means of the TOF, an expert anaesthesiologist inserted the i-gel. We assessed the number of attempts that are needed, as well as the time of the performance. The peak pressure in the airway and the tidal volume were recorded in both groups. presented as mean ± SD. Failure for the i-gel insertion at the first attemp occurred in 1 patient of each group (6,5%) and the mean time for proper i-gel insertion was similar in both group.