La utilidad de la mascarilla laríngea en comparación con el tubo endotraqueal en anestesia para mastectomía

Sosa-Jaime, Néstor Armando; Pérez-Valverde, Sandra Lorena; Rendón-Arroyo, María Elena
January 2009
Revista Mexicana de Anestesiologia;jan-mar2009, Vol. 32 Issue 1, p26
Academic Journal
Objective: We compared the usefulness of the laryngeal mask (LM) vs. the endotracheal tube (ET) for the management of the upper respiratory tract in patients subjected to mastectomy. Material and methods: It was studied a total amount of 207 patients subjected to modified radical mastectomy, with a physical condition ranging from ASA I to III. The patients were divided into two groups: Group I, LM, 104 patients and Group II, ET, 103 patients. Both groups were managed through general anesthesia balanced with sevoflurane, fentanyl, and vecuronium. The ventilation was kept by a semi-closed circuit with controlled mechanical ventilation. Results from the 104 patients of the Group I (LM): in 7 patients the placing of the LM was very difficult, and it was impossible in another one, due to escapes in ventilation. Therefore, it was necessary to practice tracheal intubation; the pharyngeal pain was present in the 10% of the patients. In the Group II (ET), with 103 patients, intubation was found difficult in 17 patients, and it was necessary to use fibrolaryngoscopy in 2 of the patients; pharynx pain was present in the 55% of the patients (p < 0.05). In the ET placing, it was found an increase in cardiac frequency with a significant statistical difference (p < 0.05). The medicine (drugs) consumption was lower for the ML Group with a significant statistical difference for vacuronium (p < 0.05). Conclusion: The use of LM in patients subjected to mastectomy is safe and useful. It presents advantages over ET. We noticed a great usefulness in the use of LM in this kind of surgeries, where the complication possibility is reduced to a minimum and the patients go home with fewer problems in the upper respiratory tract.


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