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Effects of laryngeal mask ventilation on postoperative atelectasis in children undergoing day surgery: a randomized
Weiwei Cai1, Wei Gu2, Huanhuan Ni1
1Department of Anesthesiology, Children's Hospital of Nanjing Medical University, Nanjing, 210000, China.
Insights
Laryngeal mask mechanical ventilation significantly reduces postoperative atelectasis in children undergoing day surgery. This method is recommended for airway management due to lower incidence and severity of lung complications.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Respiratory Medicine
Background:
- Postoperative atelectasis is a common complication in pediatric day surgery.
- Effective airway management strategies are crucial for minimizing respiratory complications.
Purpose of the Study:
- To compare the efficacy of laryngeal mask mechanical ventilation versus spontaneous breathing in preventing postoperative atelectasis in children undergoing day surgery.
- To evaluate the incidence and severity of atelectasis between the two ventilation methods.
Main Methods:
- A randomized controlled trial involving 46 children aged 3-7 years undergoing elective day surgery.
- Participants were divided into spontaneous breathing and laryngeal mask mechanical ventilation groups.
- Atelectasis incidence and severity were assessed pre-induction and post-operation, alongside vital signs and complications.
Main Results:
- The incidence of atelectasis was significantly lower in the mechanical ventilation group (39.13%) compared to the spontaneous breathing group (91.30%) (P=0.001).
- The severity of postoperative atelectasis was also significantly reduced with mechanical ventilation (P<0.05).
- No significant differences were observed in intraoperative vital signs or baseline data between groups (P>0.05).
Conclusions:
- Laryngeal mask mechanical ventilation is effective in reducing both the incidence and severity of postoperative atelectasis in pediatric day surgery.
- This ventilation strategy is associated with minimal complications like reflux or aspiration.
- Mechanical ventilation using a laryngeal mask is recommended for airway management in this patient population.
Background:
To compare the effects of laryngeal mask mechanical ventilation and preserved spontaneous breathing on postoperative atelectasis in children undergoing day surgery.
Methods:
Children aged 3-7 who underwent elective day surgery were randomly divided into a spontaneous breathing group (n = 23) and a mechanical ventilation group (n = 23). All children enrolled in this trial used the same anesthesia induction protocol, the incidence and severity of atelectasis before induction and after operation were collected. In addition, the baseline data, intraoperative vital signs, ventilator parameters and whether there were complications such as reflux and aspiration were also collected. SPSS was used to calculate whether there was a statistical difference between these indicators.
Results:
The incidence of atelectasis in the spontaneous breathing group was 91.30%, and 39.13% in the mechanical ventilation group, and the difference was statistically significant (P = 0.001). There was a statistically significant difference in carbon dioxide (P < 0.05), and the severity of postoperative atelectasis in the mechanical ventilation group was lower than that in the spontaneous breathing group (P < 0.05). In addition, there were no significant differences in the vital signs and baseline data of the patients (P > 0.05).
Conclusion:
Laryngeal mask mechanical ventilation can reduce the incidence and severity of postoperative atelectasis in children undergoing day surgery, and we didn't encounter any complications such as reflux and aspiration in children during the perioperative period, so mechanical ventilation was recommended to be used for airway management.
Trial Registration:
The clinical trial was registered retrospectively at the Chinese Clinical Trial Registry. ( https://www.chictr.org.cn . Registration number ChiCTR2300071396, Weiwei Cai, 15 May 2023).
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