Use of view-adjustable video laryngeal mask versus endotracheal  intubation for airway management during anaesthesia for arthroscopic  surgery: a randomized trial Chun-Jing Genga* , Guang-Lei Sub* , Ying Denga , Zhu-Kai Conga , Dan-dan Fenga , Si-Yuan Zhanga ,  Hai-Li Caoa and Hong Zenga

aDepartment of Anesthesia, Peking University Third Hospital, China; bDepartment of Anesthesia, Shanxi Provincial People’s Hospital,  China

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).

    Publication 01Arthroscopic surgery-Peking University 3rd Hospital 2025