Pharyngo-laryngeal discomfort after breast surgery: Comparison between orotracheal intubation and laryngeal mask

Sore throat and dysphonia are a significant source of postoperative discomfort for patients scheduled for breast surgery who have been intubated for general anaesthesia. The aim of this study was to compare the incidence of postoperative pharyngo-laryngeal pain and dysphonia in the use of the laryngeal mask airway (LMA) or tracheal intubation in these patients. In a prospective, double-blind, randomised clinical trial we studied 53 women undergoing elective breast surgery to test the hypothesis that the use of the LMA could reduce the incidence of pharyngo-laryngeal morbidity compared with tracheal intubation. Postoperative sore throat and hoarseness were assessed at 6 and 24 h by a standardised interview. The incidence of postoperative sore throat was significantly higher in the case of tracheal intubation at 6 h (74% vs. 27%, p = 0.0003) and at 24 h (27% vs. 0%, p = 0.004). The incidence of hoarseness was significantly higher in the tracheal intubation group than in the LMA group at 6 h after surgery (40% vs. 15%, p = 0.04), but not at 24 h. Compared with tracheal intubation, the use of the LMA is associated with a lower incidence of postoperative sore throat and hoarseness and may contribute for improving patient comfort after breast surgery.