ArticleArthroscopy, sports medicine, and rehabilitation2025
General Anesthesia Using Laryngeal Mask Airway Ventilation With Low-Dose Neuromuscular Blockade Is Safe and Effective for Patients Undergoing Hip Arthroscopy.
Article in Arthroscopy, sports medicine, and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To investigate safety and efficacy of a general anesthesia protocol using laryngeal mask airway (LMA) ventilation without endotracheal intubation (ETT) in the setting of a low dosage of neuromuscular blockade (NMBA) for patients undergoing hip arthroscopy. Methods: Patients who underwent hip arthroscopy for femoroacetabular impingement syndrome at a single institution from 2014 to 2024 were retrospectively analyzed. Those who underwent hip arthroscopy for non-femoroacetabular impingement syndrome indications and those with a concomitant periacetabular osteotomy were excluded. General anesthesia was administered with propofol and sevoflurane, with LMA ventilation. A low-dose (10-50 mg) NMBA agent (rocuronium) was given before hip distraction. The primary outcome of interest was pulmonary aspiration. Secondary outcomes of interest included conversion to ETT and operating room time. Results: This study included 1,169 cases (49.8% female) with mean age 37.8 years (± 11.0) and body mass index 24.4 (± 3.9). In total, 64.0% were American Society of Anesthesiologists (ASA) class I, 34.8% class II, and 1.2% class III. In 24 cases, patients underwent ETT without attempting LMA as a result of preoperative aspiration risk factors. Of the 1,145 cases that underwent LMA with NMBA, mean dose of rocuronium given was 20.4 mg, and no patients experienced pulmonary aspiration or anesthesia complications. Twenty-one cases (1.8%) required conversion to ETT as the result of poor LMA fit or ventilation leakage. ASA class was not associated with LMA-to-ETT conversion ( Conclusions: Administration of general anesthesia using LMA ventilation with a low dosage of neuromuscular blockade is safe and effective for patients undergoing hip arthroscopy. The rate of conversion to endotracheal intubation was low and showed no association with ASA classification. Level of Evidence: Level IV, retrospective therapeutic case series.
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