Effect of airway management method on hypothermia in patients undergoing laparoscopic gynecologic surgery: tracheal intubation, supreme laryngeal mask, and i-gel laryngeal mask.

Objective: This study aimed to assess the association between different airway management methods and perioperative hypothermia in gynecologic laparoscopic surgery.

Methods: This single-center prospective cohort observational study included patients who underwent gynecologic laparoscopic surgery between September 2022 and February 2023. A total of 531 patients scheduled for non-emergent surgery were recruited and randomly assigned to the tracheal intubation group (T group) (n = 153), supreme laryngeal mask group (L group) (n = 156), or i-gel laryngeal mask group (i group) (n = 151). Following anesthesia induction, the primary outcome was the incidence of intraoperative hypothermia at the end of surgery. Secondary outcomes included final core body temperature, incidence of nosebleeds, flushing and fluid administration, urine output, and other relevant parameters. Multivariate logistic regression analyses were conducted to identify risk factors associated with hypothermia.

Results: The incidence of postoperative hypothermia in the L and i groups was significantly lower than of the T group (P < 0.05). At the end of surgery, the core body temperature in the T group was also lower than in the L and i groups (P < 0.05). Extubation and recovery times differed significantly among the three groups, with the T group showing longer durations compared to the two laryngeal mask groups (P < 0.05). During postoperative follow-up, the incidence of nasal bleeding in the T group was higher than of the other two groups (P < 0.05). No significant differences were observed in the incidence of other postoperative complications (P > 0.05).

Conclusion: In patients undergoing gynecologic laparoscopic surgery, tracheal intubation is associated with a higher likelihood of perioperative hypothermia compared to laryngeal mask use.