Feasibility of laryngeal mask anesthesia combined with nerve block in adult patients undergoing internal fixation of rib fractures: a prospective observational study
Abstract Background The laryngeal mask airway (LMA) is occasionally used in internal fixation of rib fractures. We evaluated the feasibility of general anesthesia with an LMA associated to a thoracic paravertebral block (TPB) and/or an erector spinae plane block (ESPB) for internal fixation of rib f...
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12871-020-01082-y |
| _version_ | 1819038083746627584 |
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| author | Jun Cao Xiaoyun Gao Xiaoli Zhang Jing Li Junfeng Zhang |
| author_facet | Jun Cao Xiaoyun Gao Xiaoli Zhang Jing Li Junfeng Zhang |
| author_sort | Jun Cao |
| collection | DOAJ |
| description | Abstract Background The laryngeal mask airway (LMA) is occasionally used in internal fixation of rib fractures. We evaluated the feasibility of general anesthesia with an LMA associated to a thoracic paravertebral block (TPB) and/or an erector spinae plane block (ESPB) for internal fixation of rib fractures. Methods Twenty patients undergoing unilateral rib fracture fixation surgery were enrolled. Each patient received general anesthesia with an LMA combined with TPB and/or ESPB, which provided a successful blocking effect. All patients received postoperative continuous analgesia (PCA) with 500 mg of tramadol and 16 mg of lornoxicam, and intravenous injection of 50 mg of flurbiprofen twice a day. Our primary outcomes including the partial pressure of arterial oxygen (PaO2) and arterial carbon dioxide (PaCO2) were measured preoperatively and on the first day after surgery. Secondary outcomes including the vital signs, ventilation parameters, postoperative numerical rating scale (NRS) pain scores, the incidence of postoperative nausea and vomiting (PONV), perioperative reflux and aspiration, and nerve block-related complications were also evaluated. Results Thirteen men and seven women (age 35–70 years) were enrolled. Six (30%) had a flail chest, nine (45%) had hemothorax and/or pneumothorax, and two (10%) had pulmonary contusions. The postoperative PaO2 was higher than the preoperative value (91.2 ± 16.0 vs. 83.7 ± 15.9 mmHg, p = 0.004). The preoperative and postoperative PaCO2 were 42.1 ± 3.7 and 43.2 ± 3.7 mmHg (p = 0.165), respectively. Vital signs and spontaneous breathing were stable during the surgery. The end-tidal carbon dioxide concentrations (EtCO2) remained within an acceptable range (≤ 63 mmHg in all cases). NRS at T1, T2, and T3 were 3(2,4), 1(1,3), and 0(0,1), respectively. None had PONV, regurgitation, aspiration, and nerve block-related complications. Conclusions The technique of laryngeal mask anesthesia combined with a nerve block was feasible for internal fixation of rib fractures. Trial registration Current Controlled Trials ChiCTR1900023763 . Registrated on June 11, 2019. |
| first_indexed | 2024-12-21T08:31:41Z |
| format | Article |
| id | doaj.art-27e1d02243654ab2930af0870e629caa |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-21T08:31:41Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-27e1d02243654ab2930af0870e629caa2022-12-21T19:10:10ZengBMCBMC Anesthesiology1471-22532020-07-012011710.1186/s12871-020-01082-yFeasibility of laryngeal mask anesthesia combined with nerve block in adult patients undergoing internal fixation of rib fractures: a prospective observational studyJun Cao0Xiaoyun Gao1Xiaoli Zhang2Jing Li3Junfeng Zhang4Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalAbstract Background The laryngeal mask airway (LMA) is occasionally used in internal fixation of rib fractures. We evaluated the feasibility of general anesthesia with an LMA associated to a thoracic paravertebral block (TPB) and/or an erector spinae plane block (ESPB) for internal fixation of rib fractures. Methods Twenty patients undergoing unilateral rib fracture fixation surgery were enrolled. Each patient received general anesthesia with an LMA combined with TPB and/or ESPB, which provided a successful blocking effect. All patients received postoperative continuous analgesia (PCA) with 500 mg of tramadol and 16 mg of lornoxicam, and intravenous injection of 50 mg of flurbiprofen twice a day. Our primary outcomes including the partial pressure of arterial oxygen (PaO2) and arterial carbon dioxide (PaCO2) were measured preoperatively and on the first day after surgery. Secondary outcomes including the vital signs, ventilation parameters, postoperative numerical rating scale (NRS) pain scores, the incidence of postoperative nausea and vomiting (PONV), perioperative reflux and aspiration, and nerve block-related complications were also evaluated. Results Thirteen men and seven women (age 35–70 years) were enrolled. Six (30%) had a flail chest, nine (45%) had hemothorax and/or pneumothorax, and two (10%) had pulmonary contusions. The postoperative PaO2 was higher than the preoperative value (91.2 ± 16.0 vs. 83.7 ± 15.9 mmHg, p = 0.004). The preoperative and postoperative PaCO2 were 42.1 ± 3.7 and 43.2 ± 3.7 mmHg (p = 0.165), respectively. Vital signs and spontaneous breathing were stable during the surgery. The end-tidal carbon dioxide concentrations (EtCO2) remained within an acceptable range (≤ 63 mmHg in all cases). NRS at T1, T2, and T3 were 3(2,4), 1(1,3), and 0(0,1), respectively. None had PONV, regurgitation, aspiration, and nerve block-related complications. Conclusions The technique of laryngeal mask anesthesia combined with a nerve block was feasible for internal fixation of rib fractures. Trial registration Current Controlled Trials ChiCTR1900023763 . Registrated on June 11, 2019.http://link.springer.com/article/10.1186/s12871-020-01082-yLaryngeal mask anesthesiaRib fracturesThoracic paravertebral blockErector spinae plane block |
| spellingShingle | Jun Cao Xiaoyun Gao Xiaoli Zhang Jing Li Junfeng Zhang Feasibility of laryngeal mask anesthesia combined with nerve block in adult patients undergoing internal fixation of rib fractures: a prospective observational study BMC Anesthesiology Laryngeal mask anesthesia Rib fractures Thoracic paravertebral block Erector spinae plane block |
| title | Feasibility of laryngeal mask anesthesia combined with nerve block in adult patients undergoing internal fixation of rib fractures: a prospective observational study |
| title_full | Feasibility of laryngeal mask anesthesia combined with nerve block in adult patients undergoing internal fixation of rib fractures: a prospective observational study |
| title_fullStr | Feasibility of laryngeal mask anesthesia combined with nerve block in adult patients undergoing internal fixation of rib fractures: a prospective observational study |
| title_full_unstemmed | Feasibility of laryngeal mask anesthesia combined with nerve block in adult patients undergoing internal fixation of rib fractures: a prospective observational study |
| title_short | Feasibility of laryngeal mask anesthesia combined with nerve block in adult patients undergoing internal fixation of rib fractures: a prospective observational study |
| title_sort | feasibility of laryngeal mask anesthesia combined with nerve block in adult patients undergoing internal fixation of rib fractures a prospective observational study |
| topic | Laryngeal mask anesthesia Rib fractures Thoracic paravertebral block Erector spinae plane block |
| url | http://link.springer.com/article/10.1186/s12871-020-01082-y |
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