ABSTRACT

Introduction: The objective of this study was to compare the practicality and efficacy of utilizing

a view-adjustable video laryngeal mask (SafeLM) versus endotracheal intubation (ETI) in the

context of arthroscopic shoulder surgery.

Patients and Methods: A randomized controlled trial enrolled 100 patients undergoing

arthroscopic shoulder surgery, randomly assigned to the SafeLM group (n = 50) or ETI group (n

= 50). The primary outcome measure was hemodynamic parameters, while mechanical ventilation

parameters, complications, and the quality of anaesthesia recovery were considered as secondary

outcomes. These parameters were then compared between the two groups.

Results: During the intubation and extubation procedures, the SafeLM group demonstrated

significantly lower mean arterial pressure and heart rate compared to the ETI group (p < 0.001).

Furthermore, the airway pressure at T2 and T3 was notably lower in the SafeLM group compared

to the ETI group (p < 0.001). However, there were no statistically significant differences in oxygen

saturation observed between the two groups at any time point. Both groups were equally capable

of quickly establishing a surgical airway when necessary. Notably, a smaller proportion of patients

in the SafeLM group exhibited negative reactions during tube removal. Additionally, there was a

statistically significant difference in the occurrence of post-operative sore throat, difficulty

swallowing, choking, and coughing between the two groups (p < 0.001).

Conclusions: The utilization of SafeLM may result in enhanced regulation of blood pressure and

heart rate among patients who undergo arthroscopic surgery for the shoulder while in the side

decubitus position.

HIGHLIGHTS

1. Compared with endotracheal intubation (ETI) group, view-adjustable video laryngeal mask

(SafeLM) group had smaller changes in mean arterial pressure (MAP) and heart rate (HR)

during the intubation and extubation phase (p < 0.001).

2. In supine and lateral decubitus position, the airway pressure (AP) in the SafeLM group is

significantly lower than in the ETI group (p < 0.001).

3. There were no statistically significant differences in oxygen saturation (SPO2) observed

between the two groups at any time point during the surgical procedure (p > 0.050).

4. During the extubation phase, cough choking was significantly lower in the SafeLM group

than in the ETI group (p < 0.001).

5. Compared with endotracheal intubation (ETI) group, the occurrence of post-operative sore

throat, difficulty swallowing, choking, and coughing in the SafeLM group are significantly

lower than in the ETI group (p < 0.001).

6. Compared with endotracheal intubation (ETI) group, patients in the SafeLM group being

more satisfied (p < 0.001).