Comparison of GMA-Tulip laryngeal mask and tracheal intubation in robotic-assisted laparoscopic proctectomy

doi:10.11958/20253402

Abstract

Abstract:

Objective To compare the differences in airway management between GMA-Tulip laryngeal mask and tracheal intubation in robot-assisted laparoscopic rectal resection surgery. Methods Data were collected from 60 patients who underwent robot-assisted laparoscopic rectal resection under general anesthesia in Tianjin Union Medical Center, and patients were randomly divided into the GMA-Tulip laryngeal mask group and the endotracheal intubation group using a random number table, with 30 cases in each group. The peak airway pressure (Ppeak) in the trendelenburg position and oropharyngeal leak pressure (OLP) were observed in the GMA-Tulip laryngeal mask group. The number and duration of insertion, heart rate (HR) and mean arterial pressure (MAP) before insertion (T1), immediately after insertion (T2), before extubation and removal of the laryngeal mask (T3), immediately after extubation (T4), the arterial partial pressure of oxygen [p（O₂）]after entering the operating room (T0), at the 1st and 2nd hours, the occurrence of restlessness, choking, sore throat and hoarseness during the anesthetic emergence and the occurrence of postoperative pulmonary complications (PPCs) whinin 7 days were compared between the two groups. Results The Ppeak of the trendelenburg position was lower than that of the OLP in the GMA-Tulip laryngeal mask group. The insertion time of the GMA-Tulip laryngeal mask group was shorter than that of intubation group. There was no statistically significant difference in the number of insertion between the two groups (P > 0.05). The HR and MAP at T2 and T4 were respectively higher than those at T1 and T3 within the same group (P < 0.05), and there were no statistically significant differences in HR and MAP at T1 and T3 between the two groups (P > 0.05). The HR and MAP of T2 and T4 were lower in the GMA-Tulip laryngeal mask group than those of the tracheal intubation group (P < 0.05). There was no statistically significant difference in p（O₂）at T0, 1st and 2nd hours intraoperatively between the two groups (P > 0.05). There were no statistically significant differences in the incidence of sore throat and hoarseness during the anesthetic emergence, as well as the incidence of PPCs within 7 days between the two groups (P > 0.05). The total incidence of complications during emergence and the total incidence of PPCs within 7 days were lower in the GMA-Tulip laryngeal mask group than those in the endotracheal intubation group (P < 0.05). Conclusion The application of the GMA-Tulip laryngeal mask for airway management during robot-assisted laparoscopic rectal resection under general anesthesia offers advantages over endotracheal intubation in maintaining hemodynamic stability and reducing postoperative complications.

Key words: proctectomy, robotic surgical procedures, anesthesia, general, hemodynamics, airway management, postoperative comlications, GMA-Tulip

CLC Number:

R614.2

Figures/Tables 7

References 17

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组别	男性	年龄/ 岁	BMI/ （kg/m²）	麻醉时间/min	手术时间/min
插管组	16（53.3）	61.33±5.66	24.30±3.51	224.83±60.54	200.17±50.07
喉罩组	18（60.0）	58.70±6.90	23.83±2.83	225.50±42.72	197.50±40.68
χ²或t	0.271	1.616	0.569	0.049	0.204

组别	男性	年龄/ 岁	BMI/ （kg/m²）	麻醉时间/min	手术时间/min
插管组	16（53.3）	61.33±5.66	24.30±3.51	224.83±60.54	200.17±50.07
喉罩组	18（60.0）	58.70±6.90	23.83±2.83	225.50±42.72	197.50±40.68
χ²或t	0.271	1.616	0.569	0.049	0.204

组别	置入时间/s	置入次数/次
插管组	16.77±2.33	1.03±0.18
喉罩组	15.47±1.76	1.03±0.18
t	2.441^＊	0.000

组别	置入时间/s	置入次数/次
插管组	16.77±2.33	1.03±0.18
喉罩组	15.47±1.76	1.03±0.18
t	2.441^＊	0.000

组别	T1	T2	T3	T4
插管组	63.03±9.52	74.90±10.30^a	66.00±14.09	78.00±6.50^ab
喉罩组	64.87±10.31	68.00±11.09^a	62.23±9.26	67.60±10.95^b
t	0.715	2.497^＊	1.224	3.218^＊