Application value of using a SaCo videolaryngeal mask airway combined with a bronchial blocker in patients undergoing minimally invasive thoracoscopic surgery.

Abstract

Objective: To investigate the efficacy of the SaCo videolaryngeal mask airway (VLMA) in combination with a bronchial blocker in patients undergoing minimally invasive thoracoscopic surgery.

Methods: A retrospective analysis was conducted on the clinical data of 120 patients who underwent minimally invasive thoracoscopic surgery from January 2022 to December 2023. Patients were grouped based on their treatment methods: 68 patients who received the SaCo VLMA combined with a bronchial blocker intraoperatively were designated as the L group, while 52 patients who received a tracheal tube combined with a bronchial blocker intraoperatively were designated as the E group. Heart rate (HR) and mean arterial pressure (MAP) were compared between the two groups at several time points: prior to anesthesia induction (P1), immediately after anesthesia induction (P2), 1 minute after the insertion of the tracheal tube or placement of the laryngeal mask airway (P3), and 1 minute after the removal of the tracheal tube or laryngeal mask airway (P4). Additionally, the following parameters were recorded and compared: peak airway pressure (Ppeak), airway plateau pressure (Pplat), and pulse oxygen saturation (SpO₂) at various time points: 5 minutes after the insertion of the tracheal tube or placement of the laryngeal mask airway (T1), 3 minutes after two-lung ventilation (T2), 5 minutes after one-lung ventilation (T3), and 1 hour after one-lung ventilation (T4). Other observations included the degree of lung collapse during surgery, awakening quality, time to extubation or removal of the laryngeal mask airway, overall recovery quality, and incidence of complications.

Results: Compared to the E group, the L group exhibited significantly higher HR and MAP at time points P2, P3, and P4 (P < 0.05). The L group also demonstrated lower Ppeak and Pplat levels from T1 to T4 compared to the E group (P < 0.05). There was no significant difference in SpO₂ levels between the two groups from T1 to T4 (P > 0.05). The time to removal of the tracheal tube or laryngeal mask airway was significantly shorter in the L group than in the E group (P < 0.05). The utilization rate of vasoactive drugs was lower in the L group compared to the E group (P < 0.05). The modified Aldrete recovery scores at 30 minutes and 2 hours postoperatively were significantly higher in the L group than in the E group (P < 0.05). The Quality of Recovery Scale (QoR-15) score at 24 hours postoperatively was also higher in the L group compared to the E group (P < 0.05). Furthermore, the incidence of complications was significantly lower in the L group than in the E group (P < 0.05).

Conclusion: The use of the SaCo videolaryngeal mask airway combined with a bronchial blocker in minimally invasive thoracoscopic surgery, compared to tracheal tube placement, can effectively reduce the requirement for vasoactive drugs, improve ventilation outcomes, stabilize hemodynamics, accelerate postoperative awakening, reduce the incidence of postoperative complications, and enhance the quality of postoperative awakening. These findings highlight the potential of this approach as a valuable reference for clinical practice.