Clinical research on the use of flexible laryngeal mask, classic laryngeal mask and supreme laryngeal mask in breast surgery under general anesthesia

Objective Randomized controlled research on the safety of the use of flexible laryngeal mask,classic laryngeal mask and Supreme laryngeal mask in breast surgeries under general anesthesia.Methods Sixty ASA Ⅰ-Ⅱpatients aged 27 y-77 y weighing 51 kg-82 kg scheduled for breast surgery under general anesthesia were randomly divided into 3 groups (n=20),according to random number table:flexible laryngeal mask group (group A),classic laryngeal mask group (group B) and Supreme laryngeal mask group (group C).After induction of anesthesia,laryngeal mask insertion was performed,respectively.Noninvasive blood pressure (BP),heart rate (HR) and bispectral index(BIS) were recorded at the time before induction,the time before and just the time of laryngeal mask insertion,at 1,2,3,5,10 min after laryngeal mask insertion was complete.Observe the hemodynamic response and complications of laryngeal mask insertion.Results Patients of three groups had high one-time success rate above 90％,and short intubation time(＜1 min).BIS of three groups all decreased significantly[group A (93±5) vs (39±7),group B (96±3) vs (39±9),group C (95±5) vs (39±9),P＜0.05].In group A,BP was significantly decreased after induction [systolic blood pressure (SBP)(134±13) mmHg vs (109±12) mmHg (1 mmHg=0.133 kPa),diastolic blood pressure (DBP) (77±10) mmHg vs (64±9) mmHg,mean artery pressure (MAP) (90±11) mmHg vs (74±9) mmHg,P＜0.05].In group B,there was no significant change in BP and HR.While in group C,there was significant change in HR and BP [HR (77±10) bpm vs (68±9) bpm,SBP (127±28) mmHg vs (107±15) mmHg,DBP(72±14) mmHg vs (58±11) mmHg,MAP (85 ±15) mmHg vs (70±10) mmHg,P＜0.05].Insertion and extubation of laryngeal mask didn't cause violent hemodynamic responses.There were no significant differences among the hemodynamic responses of three groups,during the period of induction of anesthesia and laryngeal mask insertion.And the intubation time,recovery time and extubation time were not different among three groups.There were less complications of intubation and extubation observed in group A,compared with other two groups.Conclusions Flexible laryngeal mask,classic laryngeal mask and Supreme laryngeal mask can all prevent hemodynamic responses to intubation,and flexible laryngeal mask has advantage in reducing complications produced by intubation than other two kinds of laryngeal mask. Key words: General anesthesia;  Breast surgery;  Laryngeal mask ;  Hemodynamic response ;  Complications