Comparison between novel double-tube laryngeal mask and endotracheal intubation in radiofrequency ablation for treating gastroesophageal reflux

Abstract:

Objective：To compare the safety and efficacy of the novel double-tube laryngeal mask airway（LMA） and endotracheal tube（ETT） on Stretta radiofrequency ablation therapy under general anesthesia in patients with gastroesophageal reflux disease （GERD）. Methods：A total of 30 patients with GERD treated by radiofrequency therapy under general anesthesia were randomly divided into the LMA group（L group） and the ETT group（T group）. After preoxygenation，the routine intravenous anesthesia was performed，the LMA or ETT was inserted and the reasonable depth of anesthesia was maintained. The time of successful placement of the radiofre－quency catheter，mean arterial pressure（MAP），heart rate（HR），pulse oxygen saturation（SPO2），end-tidal carbon dioxide partial pres－sure（PetCO2） and airway pressure at seven different time points，operation time，extubation or mask-removal time，the satisfaction of endoscopic physicians and patients，and the incidence of reflux aspiration were recorded. SPSS 22.0 was used to perform the data statistical analysis，x±s was used to demonstrate measurement data，repeated-measure variance analysis was used to perform the intergroup comparison of repeated-measure data，t-test was adopted for intergroup comparison and constituent ratio or constituent rate was used to demonstrate the numeration data. Results：In the L group，the successful placement time of radiofrequency catheter was significantly shorter than that in the T group（P<0.05）[（22.1±4.3） s vs. （76.0±6.3） s，P=0.000 ]，the operation time and postopera－tive extubation time were shorter than those in the T group（P<0.05），the satisfaction score of patients and endoscopy doctors was better than that in the T group. The HR and MAP in the T group were significantly higher than those in the L group at T1 time point（P<0.05）. The airway pressure in the L group was significantly higher than that in the T group at T1，T2 and T4 time point. There was no significant difference in ventilation oxygenation between the two groups，and no adverse events such as reflux and aspi－ration. Conclusion：Novel double-tube laryngeal mask airway，with characteristics of simple operation，proper airway sealing function and stable hemodynamics，can significantly shorten the opera－tion time，and improve the perioperative comfort of patients and the satisfaction of endoscopists，which can effectively and safely re－place ETT in the radiofrequency treatment of GERD.