[INJURY PREVENTION WHILE ENSURING THE AIRWAY DURING SURGERY IN THE NOSE AND SINUSES.]

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Airway Management

Background:

• Tracheal intubation is a common method for airway management during pediatric surgery.
• Potential complications include airway trauma and stress response.
• Laryngeal mask airway (LMA) offers an alternative with potentially fewer adverse effects.

Purpose of the Study:

• To compare the flexible reinforced laryngeal mask (LMA FlexibleTM) with endotracheal intubation in children undergoing nasal and paranasal sinus surgery.
• To evaluate the stress response, cardiovascular system reactions, and airway complication frequencies associated with each method.

Main Methods:

• A comparative study involving 140 pediatric patients (aged 3-17 years).
• Analysis of blood pressure, heart rate, glucose, and cortisol levels.
• Assessment of airway injuries and post-operative complications such as cough, hoarseness, and sore throat.

Main Results:

• LMA FlexibleTM demonstrated minimal negative impact on hemodynamics.
• Lower stress response observed with LMA FlexibleTM, indicated by reduced cortisol (3.7%) and glucose (11.4%) levels compared to tracheal intubation.
• Fewer post-removal complications with LMA FlexibleTM: reduced cough (21%), hoarseness (10%), and sore throat (26%) compared to extubation.

Conclusions:

• Flexible reinforced laryngeal mask airway is a safer and less traumatic option for airway management during nasal and paranasal sinus surgery in children.
• LMA FlexibleTM leads to a less pronounced stress response and fewer airway-related complications post-procedure.