| Objective To evaluate the effect of endoscopic laryngeal mask on perioperative airway management and postoperative recovery of patients undergoing gastric endoscopic submucosal dissection (ESD). Methods A total of 90 patients, aged 18 to 64 years, BMI 18-25 kg/m2, ASA physical status Ⅰ or Ⅱ, who underwent elective ESD were randomly divided into the endoscopic laryngeal mask group (group J) and the endotracheal tube group (group C) (n = 45 in each group). After induction of general anesthesia, patients in the J group received endoscopic laryngeal mask airway ventilation, and the endoscope was inserted through the endoscopic channel of the laryngeal mask. Patients in the C group received tracheal intubation, and the endoscopy was inserted through the mouth. The operative time, extubation time and PACU residence time were recorded for two groups. The successful time and one-time success rate of intubation, and the insertion time and withdrawal rate of endoscopy were recorded. MAP, HR were recorded when the patient entered the room (T0), at the time of intubating (T1), inserting gastroscopy (T2), exiting gastroscopy (T3), extubation (T4) and leaving PACU (T5). The average airway pressure and peak airway pressure at T1, T2, and T3 of the two groups were recorded. The airway sealing pressure and endoscopic view grading system (EVGS) grading of the J group were recorded before and after changing the position, and at the end of surgery. The adverse reactions during the perioperative period in both groups were recorded. The satisfaction of anesthesiologists and gastroenterologists were recorded. Results The successful time of intubation in the J group was significantly shorter than that in the C group, and there was no significant difference in the one-time success rate of intubation, and the insertion time and withdrawal rate of endoscopy between the two groups. The extubation time and PACU residence time of the J group were significantly shorter than those of the C group. Compared with T0, HR and MAP levels were significantly increased at T1 and T4 in both groups. Compared with the C group, HR and MAP levels were significantly decreased at T1 and T4 in the J group (P＜0.05). Endoscopic laryngeal mask showed good sealing and alignment in the J group. The incidence of choking cough during extubation, and postoperative pharyngeal pain, hoarseness in the J group is lower than those in the C group (P＜0.05). Conclusion Endoscopic laryngeal mask could shorten the success time of establishment of artificial airway in patients with gastric ESD, without interfering with digestive endoscopy operations, shorten extubation time and PACU retention time, maintain intraoperative hemodynamic stability, and reduce adverse reactions. |
