Clinical Observation Of The Feasibility Of Mechanical Ventilation Using LMA Supreme In Spinal Surgery In Prone Position

Objective: To investigate the feasibility of mechanicalventilation using laryngeal mask airway Supreme in prone position.Method：40ASA I to II patients, male or female, aged25to72,body weight46~85kg, undergoing elective lumbar thoracic surgery,were included in the study. Before the anesthesia induction, patientswere asked to lie prostrate on the operation table by themselves.LMA Supreme were selected according to the body weight of thepatients, then intubated after the induction, and followed bymechanical ventilation. MAP, HR, PE TCO2, SpO2, Vt and Ppeak atthe time before the induciton (T0), the time of the LMA insertion(T1),5min (T2),15min (T3),30min (T4)&60min (T5) after theintubation, and the time after extubation (T6) were recorded, aswhile as the mask ventilation tidal volume, number of attempts andtotel time of the intubation, number of the intubations which need tobe adjusted, and the success rate of the intubation by first attempt.Fiberoptic bronchoscopy score and oropharyngeal leak pressurewere also recorded. Nausea&vomiting, choking, aspiration,hypoxemia and the extent of blood around the laryngeal mask werenoted, alongside with sore throat, hoarseness, difficulty swallowing within24hours after surgery.Result： All40cases were successfully intubated with LMASupremes, and completed the surgeries under mechanical ventilation.The success rate of the intubation by first attempt is87.5%. AllMAPs at the time points after intubation were lower than thebaseline (P<0.05), and differences of HR, Ppeak, PE TCO2&leakrate in different time point were not statistically significant. No sideeffects or complications were noted within24hours.Conclusion：Intubation of LMA Supreme in prone position hasthe advantages of easy operation, exact alignment, airtight airwayduring the mechanical ventilation, and less side effects orcomplications, therefore the need of perioperative ventilation can bemet. Anesthesia induction and LMA Supreme intubation in proneposition can reduce the number of replacements during the surgery,as well as the the potential risk of the complications caused bypositional compression.