Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjan.2012.08.001
Brazilian Journal of Anesthesiology
Scientific Article

Estudo clínico prospectivo aleatório sobre o uso da máscara laríngea Supreme® em pacientes submetidos a anestesia geral

Prospective, randomized clinical trial of laryngeal mask airway Supreme® used in patients undergoing general anesthesia

Sara R. Barreira; Camila Machado Souza; Fernanda Fabrizia; Ana Bárbara G. Azevedo; Talitha G. Lelis; Claudia Lutke

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Resumo

JUSTIFICATIVA E OBJETIVOS: Dispositivos supraglóticos são cada vez mais usados como opção à intubação traqueal durante procedimentos eletivos de complexidade variável. O objetivo deste estudo foi avaliar prospectivamente o uso clínico da máscara laríngea Supreme® (MLS) em pacientes submetidas a procedimentos cirúrgicos eletivos na mama e compará-la ao tubo endotraqueal (TE). MÉTODO: 60 pacientes submetidas a procedimentos cirúrgicos da mama sob anestesia geral foram distribuídas aleatoriamente em dois grupos de acordo com o dispositivo usado (MLS ou TE). Foram avaliados: tempo de inserção, número de tentativas para inserção, resposta hemodinâmica à inserção, presença de sangue no dispositivo usado e incidência de dor de garganta, disfagia, náuseas e vômitos no pós-operatório. RESULTADOS: Não houve diferença entre os grupos com relação ao tempo de inserção, ao número de tentativas para inserção bem-sucedida e à presença de sangue no dispositivo. A frequência cardíaca e a pressão arterial após a inserção foram maiores no grupo TE. A incidência de dor de garganta e disfagia após duas horas de pós-operatório também foi maior no grupo TE. Não houve diferença na incidência e na intensidade das complicações avaliadas após seis horas de pós-operatório. CONCLUSÕES: O uso da MLS como técnica de acesso à via aérea durante a anestesia geral em procedimentos cirúrgicos eletivos na mama é tão seguro e eficiente quanto a intubação traqueal, com a vantagem de desencadear menor resposta hemodinâmica durante a sua execução e menor incidência de dor de garganta e disfagia nas primeiras horas de pós-operatório.

Palavras-chave

Equipamentos, Máscaras laríngeas, Complicações, Anestesia geral

Abstract

BACKGROUND AND OBJECTIVES: Supraglottic airway devices are increasingly used as an option to tracheal intubation for elective procedures of varying complexity. The aim of this study was to prospectively evaluate the clinical use of the laryngeal mask airway Supreme® (LMAS) in patients undergoing elective breast surgery and compare it with endotracheal tube (ETT). METHODS: Sixty patients undergoing breast procedures under general anesthesia were randomly divided into two groups according to the device used (LMAS or ETT). Time of insertion, number of insertion attempts, hemodynamic response to insertion, presence of blood on the device used; and incidence of sore throat, dysphagia, nausea and vomiting were assessed postoperatively. RESULTS: There was no difference between groups regarding time of insertion, number of attempts for successful insertion, and presence of blood on the device. Heart rate and blood pressure after insertion were higher in ETT group. Incidence of sore throat and dysphagia was also higher in ETT group after two hours in the postoperative period. There was no difference regarding incidence and severity of complications evaluated after six hours postoperatively. CONCLUSIONS: The use of the LMAS technique to access airway during general anesthesia for elective breast surgery is as safe and effective as tracheal intubation, with the advantage of promoting smaller hemodynamic response during its management and lower incidence of sore throat and dysphagia in the first hours after surgery.

Keywords

Equipment, Laryngeal mask airway, Complications, General anesthesia

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