Application of visual laryngeal mask combined with bronchial occluder in thorascopic partial lobectomy 

Authors: Wang Guijuan, Ma Xiao-chen, Du Sheng-jie, et al. 

1. School of Anaesthesiology, Weifang Medical University, Weifang 261053, China

2. Graduate Training Bae of Linyi People's Hospital, Jinzhou Medical University

3. Department of Anesthesiology, Linyi People's Hospital

(ENG PDF) Application of visual laryngeal mask combined with bronchial occluder in thoracoscopic partial lobectomy

Objective: To explore the feasibility and advantages of visual laryngeal mask combined with bronchial occluder in thoracoscopic partial lobectomy.

Methods: Eighty patients who underwent thoracoscopic partial lobectomy under general anesthesia from Dec 2021 to May 2022 were randomly divided into visual laryngeal mask combined with bronchial occluder group (experimental group) and double-lumen bronchial catheterization group (control group) with 40 cases in each group. The incidence of postoperative intubation adverse events such as pharyngalgia and hoarseness were analyzed and compared between the two groups. Mean arterial pressure, heart rate were recorded before anesthesia induction (T0), after induction (T1), immediately after insertion of laryngeal mask or endotracheal tube (T2), 2 min (T3) after insertion of laryngeal mask or endotracheal tube, immediately after removal of laryngeal mask or endotracheal tube (T4), and 2 min (T5) after removal of laryngeal mask or endotracheal tube. The airway plateau pressures (P1, P2, P3) and oxygen saturation were recorded after 5 min of double-lung ventilation (T6), 5 min of single-lung ventilation (T7), and 5 min after recovery of double-lung ventilation after surgery (T8). The intubation positioning time, operation time, one-lung ventilation time, anesthesia time, hospital stay, 10-min one-lung ventilation lung collapse, the incidence of catheter displacement, the Aldrete recovery score, 15-item quality of recovery score before and 1 day after surgery, and postoperative satisfaction were compared between the two groups.

Results: One patient was excluded in experimental group and one in control group, and 78 patients were included. The incidences of sore throat and hoarseness in the experimental group were 5.1% and 2.6%, respectively, which were significantly lower than those in the control group (43.6% and 25.6%), and the difference was statistically significant (P<0.05). Compared with control group, experimental group had lower mean arterial pressures at T2, T4, T5 (P<0.05), lower airway platform pressure (P1, P2, P3) at T6, T7, T8 (P<0.05), higher QoR-15 score on the 1st day after operation (P<0.05), shorter hospital stay and higher postoperative satisfaction (P<0.05). There was no significant difference in other observed indexes (P>0.05).

Conclusions: Visual laryngeal mask combined with bronchial occluder can meet the requirements of one-lung ventilation in thoracoscopic partial lobectomy, and can reduce adverse reactions related to intubation, reduce perioperative circulatory fluctuations, shorten hospital stay, improve patients satisfaction, and promote the rapid recovery of patients.