Application of awaking anesthesia with laryngeal mask airway in strabismus surgery

Objective To evaluate the feasibility of the intraoperative wake-up test in strabismus surgery anaesthetized with laryngeal mask airway (LMA). Methods A total of 169 strabismus patients were randomly divided into 2 groups. The first group had general anesthesia with intraoperative wake-up test and the other group without the test. In the first group, operated muscles were first tightened with a slipknot. Then, the patient was awakened to examine the eye position. If the position was orthoptic, finish up the operation. Otherwise, general anesthesia with LMA was reinstalled and the surgical procedures were repeated until the orthoptic position was achieved.The patients who did not receive intraoperative wake-up test underwent surgery according to the preoperative assessment. Results Among 87 patients in the group with intraoperative wake-up test, three of them were not cooperative after awaking and were abandoned. All 82 patients in the group without intraoperative wake-up test finished surgeries successfully. The success rate of the group with intraoperative wake-up test was 98.85% one week after the operation, which was significantly higher than that 91.46% in the other group (P=0.030). One year after the operation, the success rates of surgery in patients with and without intraoperative wake-up test were 95.4% and 85.37% respectively. There was statistically significant difference between two groups (P=0.035). Conclusion Awaking anesthesia with LMA is safe and effective in strabismus surgery, which can improve the success rate. The patients could tolerate the LMA and complete the adjustment of eye position successfully. Key words: Surgery, strabismus; Anesthesia, awaking; Airway, mask, laryngeal