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The degree of bleeding observed following children's difficult airway management using supraglottic airway (SGA) remains a major concern. A total of 100 consecutive children were enrolled in this study to investigate the impact of SGA type on postoperative bleeding. Following endotracheal intubation, all children were randomized to receive either the circle-type endotracheal tube (ETT) or the tube combined with heparin-bonded material in the SGA (FB/ETT). The protocol for maintaining hemodynamic parameters and airway patency included continuous infusion of fentanyl citrate (6 microg x kg(-1) x min(-1) ), with the use of inhalational sevoflurane (1.5%) for endotracheal intubation, as well as routine mechanical ventilation with a tidal volume of 6 mL x kg(-1). A radial artery catheter was inserted for continuous blood pressure measurement. Postoperative bleeding from the tubes was measured using the pneumatic resistance technique and was analyzed for airway circuit type and duration. The amount of postoperative bleeding following the FB/ETT for 1 min was significantly lower than that following the conventional ETT (23 +/- 10 vs. 69 +/- 61 [micro]L, respectively; P 0.05). A total of 36 cases of hypoxemia were observed following the FB/ETT (84% of the children); however, no significant difference in the incidence of hypoxemia was seen in the two groups (P > 0.05). The postoperative bleeding from the FB/ETT was significantly less than that observed after the conventional ETT, and was similar to levels seen after extubation.Lymphatic blockade by bupivacaine-HCl affords regional pain relief in the rat.
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