The Effect Of Muscle Relaxants On Postoperative Sore Throat With Aryngeal Mask Airway Insertion

Objective:The purpose of this study was to evaluate if muscle relaxants affect the incidence and severity of postoperative sore throat in short limbs surgery with laryngeal mask airway insertion.Materials and Methods:60Patients undergoing elective saphenous vein ligation, endarterectomy were selected in First Hospital of Jilin University during June2013to December2013. ASA Ⅰ～Ⅱ level patients without severe heart and lung disease including37males and23females; age (20to70) years; weight (45～～85) kg. Exclusion criteria: Patients with original pharyngitis or sore throat; Patients with limited neck and mouth opening, oropharyngeal anatomical abnormalities, respiratory dysfunction, heart, liver, lung, kidney dysfunction and obesity.60cases subjects were randomly divided into two groups, Group A:the muscle relaxant group.Group B:non-muscle relaxant group Preoperative fasting6h, water deprivation4h without giving any sedation, analgesic drugs. The anesthesia monitor continuous monitoring of the electrocardiogram (ECG)is connected to the patient after entering operating room, mean arterial pressure (MAP), heart rate (HR), respiratory frequency (RR), pulse oximetry degrees (SpO2) were monitored, establishment of intravenous access line prone position were made.Anesthesia was induced with midazolam0.05mg/kg, fentanyl4ug/kg, etomidate3.0mg/kg, while Group A give0.15mg/kg intravenous cis atracurium, group B give an equal volume of saline. After inteavenous anesthesia inducion, an experienced user inserted the LMA with the digital technique. The cuff was inflated with air to an intracuff pressure of60cm H2O.Observe lung inflations and auscultate the chest.If the thorax fluctuation is well, no obvious leakage, begun to mechanical ventilation.If the thorax fluctuation is not well, inserted the LMA again., Endotracheal intubation is operated if three attempts to insert are fail. Anesthesia was maintained with continuous infusion of propofol4-12mg/kg· and remifentanil0.05-0.2μg/kg·min. Muscle relaxant is given at appropriate time in A group. Stop the propofol when there is10min before the end of surgery, stop the remifentanyl when there is10min before the end of surgery. Pressure(MAP) heart rate(HR) and airway pressure were recorded at the moment before laryngeal mask insertion(T1),30minute after laryngeal mask insertion(T2),60minute after laryngeal mask insertion(T3)、the moment when the surgery is over (T4).The time from the end of surgery to extubation and Aldrete score≥9points is recorded.Observed the incidence and severity of postoperative sore throat at the moment after extubation and1h,6h and24h after the end of surgery. Results:Compared with muscle relaxant group, the incidence and severity of postoperative sore throat is increaded obviously, P<0.05.Conclusion:Anesthesia without muscle relaxtant can provide satisfactory condition and has little effect on hemodynamics, but increased the incidence and severity of postoperative sore throat.