• Int Forum Allergy Rhinol · May 2018

    Randomized controlled trial comparing the supraglottic airway to use of an endotracheal tube in sinonasal surgery.

    • Austin S Adams, Todd J Wannemuehler, Benjamin Hull, Jeffanie Wu, Rakesh K Chandra, Kate VonWahlde, Matthew S Shotwell, Stephen Harvey, Michael Higgins, Kelly McQueen, and Justin H Turner.
    • Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, TN.
    • Int Forum Allergy Rhinol. 2018 May 2.

    BackgroundThe supraglottic airway (SGA) represents an alternative to endotracheal intubation (endotracheal tube [ETT]) in many types of ambulatory surgery. Adoption of the SGA has progressed slowly in sinonasal surgery due to concerns about airway protection. The purpose of this study was to compare quality of life measures and indices of airway protection between patients undergoing sinonasal surgery who were ventilated via an SGA or ETT.MethodsPatients undergoing outpatient sinonasal surgery were enrolled into a randomized, single-blind study in which patients would be ventilated with either an SGA or ETT. At the first postoperative visit, a symptom severity and quality of life questionnaire was completed. Additional objective metrics were extracted from the anesthesia record.ResultsA total of 102 patients were enrolled; 49 assigned to the SGA group and 53 assigned to the ETT group. No significant differences in swallowing function or cough were identified. SGA patients reported more difficulty returning to a normal diet (p = 0.03) with a trend toward reduced throat pain (p = 0.07) and improved phonation (p = 0.06). No significant difference in perioperative oxygen desaturations, emesis, recovery time, or airway blood penetration were identified.ConclusionWhile the use of the SGA results in patient diet modification postoperatively, it may also be associated with a reduction in throat pain and dysphonia. SGA use had no appreciable effect on postanesthesia recovery times, oxygen desaturations, or emesis. Use of the SGA in sinonasal surgery appears to be a safe and reliable option for airway management in selected adult patients undergoing routine ambulatory sinonasal surgery.© 2018 ARS-AAOA, LLC.

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