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Comparative study using laringeal mask airway, local anesthesia and sedation versus endotracheal intubation and general anesthesia in nasal surgery

Abstract:

Objective: Demonstrate the existence of other procedures, different from the classical inhalation and intravenous general techniques whereas the orotraqueal intubation (OTI) is necessary in other to maintain airway free of any kind of secretion, bleedings and to keep a continuous oxygen supply; also to demonstrate a new technological advantage: The laryngeal mask airway (LMA), which provides a pbkp_redictable controlled air supply, through this mask is possible to administrate oxygen to the patient and a huge specter of other anesthetic inhalatory agents, with a minimum stimulation, also this mask's collocation is easier than the classical intubation followed by a direct laryngoscopy. Material and Methods: Thirty patients from the Otorhinolaryngology service scheduled for rhynoseptumplasty, assigned in two aleatory groups of fifteen individuals each. The test group was managed with intravenous induction for LMA collocation, and for oxygen supply. It was maintained by a continuous infusion of propofol on sedation doses, meperidine (only one dose) for analgesia, and a local nasal anesthesia. Control group received the classical general balanced technique, OTI, with intravenous induction, and the use of enflurane for maintenance and fentanyl for analgesia. Results: Test group presented reduction in surgical bleeding, between fifty to ninety percent, as well an in the postanesthesia recovery in a twenty five percent, also this patients presented mayor alterations in cardiac frequency and a mayor CO2 retention. It was probed that used the intravenous technique as sedation doses added to an adequate regional infiltration technique at the nasal area, supplying oxygen through the LMA, provides optimal conditions for the transanesthetic period. Conclusions: We conclude that local anesthetic and the use of LMA is a good alternative technique for managing nasal surgery in patients ASAI-II.