Comparison of laryngeal mask airway with endotreacheal intubation in patients undergoing radical mastectory

Objective To compare the effects of laryngeal mask airway (LMA) and endotreacheal intubation (ET) on hemodynamics, respiratory function and stress responses in patients undergoing radical mastectory.Methods Forty patients (ASA class Ⅰ or Ⅱ), scheduled for selective radical mastectory under general anesthesia were allocated randomly to either LMA group (n=20) or ET group (n=20)with mechanial ventilation.SBP,DBP,and HR were recorded before anesthesia induction(T0),before intubation(T1),after intubation immediately(T2),at 5min(T3),10min(T4),15min(T5) after intubation,beginning of the elective radical mastectory(T6),after extubation immediately(T7).The inspiratory and expiratory tidal volume (VTI) and (VTE), minute ventialtion (VE), peak inspiratory and expiratory flow rate (PIFR) and (PEFR), peak inspiratory pressure (PIP) and mean airway resistance (RAWM) were recorded.Blood samples were taken in 10 patients from each group at 5 time points for the measurements of epinephrine (AE),norepinephrine (NE),and dopamine (DA) levels with high performance liquid chromatography. Results In group ET, SBP, DBP, HR and MAP were significantly higher than those in group LMA at T2(P0.05). VTI, VTE, VE, PIFR, PEFR, PIP and RAWM did not differ between the two groups. AE, NE and DA were also significantly higher in group ET than those in group LMA at T2 and T7 (P0.05).Conclusion Ventilation with LMA in patients undergoing radical mastectory is better than ET in keeping stable hemodynamics and producing less stress responses with smoth recovery from genenal anesthesia.