The Impaction Of Fully Deflated And Undeflated Ventilation Hood Of Laryngeal Mask Airway Supreme On The First-time Success Rate And Pharyngeal Complications

Objective:To compare the first-time insertion success rate,pharyngeal alignment,and postoperative sore throat incidence when used two different methods to operate ventilation hoods of the laryngeal mask airway Supreme.Methods:A total of 102 patients who underwent elective gynecological surgery under general anesthesia at the First Hospital of Jilin University from December 2018 to August 2019 were selected and divided into two groups（group N and group R）according to different insertion methods.In the N group（completely deflated ventilation hood group）,the safety valve was removed before the laryngeal mask was placed,and the syringe completely sucked out the gas from the laryngeal mask airway.Group R（non-deflated group）was directly inserted after the safety valve was removed.Subsequentl,after the laryngeal mask was successfully placed in the group N,the internal cuff pressure was measured after injecting 10 ml of air into the cuff,and compared with the internal cuff pressure measured after direct implementation of the LMA in group R.The two methods were used to compare the first success rate of the laryngeal mask airway Supreme,pharyngeal alignment,ventilation conditions,and the effect of intracuff pressure on the incidence of postoperative sore throat.Finally,compare differences between the two groups with statistical analysis.Results:The Supreme laryngeal mask airways were successfully inserted in 102 patients in this study with 51 in each of the N and R groups.The general data of the two groups of patients:age,weight,height,BMI,operation time,anesthesia time,Mallampati classification and ASA classification were compared between groups without significant differences（P>0.05）.The success rates of first-time Supreme laryngeal mask placement in group N and group R were 70.59%and 90.20%,respectively（P<0.05）.After the laryngeal mask was successfully inserted,the alignment conditions of the patients in group N and group R were confirmed by fiberoptic bronchoscopy,and there were 32 cases and 42 cases classified as grade 4（P<0.05）.The cuff internal pressures measured after successful implantation in group N and group R were 51.22±7.54 mmH₂O and 49.02±5.58 mmH₂O,respectively（P>0.05）.After confirming the alignment of the laryngeal mask,adjust the internal pressure of the laryngeal mask cuff with a pressure gauge to 40 cm H₂O,and ensure that the ventilation effect is good.After the operation,the incidence of nausea and vomiting in the N group and the R group after 1 hour were 7.84%and 3.92%（P>0.05）;the incidence of sore throat was 5.88%and 1.96%（P>0.05）.The incidence of sore throat in patients in group N and group R at 24 hours after operation was 1.96%and 1.96%,respectively（P>0.05）.Conclusion:（1）Inserting the Supreme Laryngeal mask airways with non-deflated ventilation hoods provides a higher first success rate and better alignment conditions than the fully deflated group.（2）When the pressure inside the Supreme laryngeal mask airway was controlled to be equal,there was no significant difference in the incidence of postoperative sore throat complications between the non-deflated group and the fully deflated group.