The effect of intraoperative transnasal humidified rapid-insufflation ventilatory exchange on emergence from general anesthesia in patients undergoing microlaryngeal surgery: a randomized controlled trial

BMC Anesthesiology

Research

Lili Feng¹  Yirong Cai¹  Wei Wei¹  Xiang Li¹  Wenxian Li¹  Yuan Han¹  Rui Fang²  Jiali Jiao³ 

[1] Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Xuhui District, 200031, Shanghai, China;Department of Otolaryngology, Eye & ENT Hospital of Fudan University, Xuhui District, Shanghai, China;Institute of Translational Medicine, Shanghai Jiao Tong University, Minhang District, Shanghai, China;

关键词: THRIVE;    Laryngeal mask;    Tubeless anesthesia;    Microlaryngeal surgery;    Emergence from general anesthesia;   

DOI  :  10.1186/s12871-023-02169-y

 received in 2022-12-19, accepted in 2023-06-08,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTransnasal humidified rapid-insufflation ventilatory exchange (THRIVE) has received extensive attention for its utility in tubeless anesthesia. Still, the effects of its carbon dioxide accumulation on emergence from anesthesia have not been reported. This randomized controlled trial aimed at exploring the impact of THRIVE combined with laryngeal mask (LM) on the quality of emergence in patients undergoing microlaryngeal surgery.MethodsAfter research ethics board approval, 40 eligible patients receiving elective microlaryngeal vocal cord polypectomy were randomly allocated 1:1 to two groups, THRIVE + LM group: intraoperative apneic oxygenation using THRIVE followed by mechanical ventilation through a laryngeal mask in the post-anesthesia care unit (PACU), or MV + ETT group: mechanically ventilated through an endotracheal tube for both intraoperative and post-anesthesia periods. The primary outcome was duration of PACU stay. Other parameters reflecting quality of emergence and carbon dioxide accumulation were also recorded.ResultsDuration of PACU stay (22.4 ± 6.4 vs. 28.9 ± 8.8 min, p = 0.011) was shorter in the THRIVE + LM group. The incidence of cough (2/20, 10% vs. 19/20, 95%, P < 0.001) was significantly lower in the THRIVE + LM group. Peripheral arterial oxygen saturation and mean arterial pressure during intraoperative and PACU stay, Quality of Recovery Item 40 total score at one day after surgery and Voice Handicap Index-10 score at seven days after surgery were of no difference between two groups.ConclusionsThe THRIVE + LM strategy could accelerate emergence from anesthesia and reduce the incidence of cough without compromising oxygenation. However, these benefits did not convert to the QoR-40 and VHI-10 scores improvement.Trial registrationChiCTR2000038652.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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