Idrees A, Khan F A
Department of Anaesthesia, Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 2000 Oct;50(10):333-8.
To investigate the use of Laryngeal Mask Airway (LMA) and its comparison with the endotracheal tube for positive pressure ventilation.
A tertiary care teaching hospital.
Fifty adult ASA I and II patients undergoing peripheral limb surgery were randomly allocated to 2 groups for LMA or endotracheal tube insertion. A standardized anaesthetic technique was used. The groups were then compared regarding haemodynamic changes on insertion as well as removal of LMA and ETT and any complications that occurred were noted.
The haemodynamic response to insertion was significantly attenuated (p < 0.05) in LMA group as compared to ETT group. The cardiovascular response to extubation was not significantly different between the groups. A higher incidence of coughing and mild hypoxaemia at extubation was noted in ETT group as compared to LMA group (p < 0.05) and blood was detected in 4 cases after LMA removal.
It is concluded that the use of LMA during positive pressure ventilation is safe in selected cases. There is an attenuated haemodynamic response to insertion of LMA as compared to endotracheal tube which will be beneficial in certain patients e.g., those with ischaemic heart disease, vascular disease and hypertensives.
探讨喉罩气道（LMA）的应用及其与气管内导管用于正压通气的比较。
一家三级护理教学医院。
50例接受外周肢体手术的成年ASA I级和II级患者被随机分为两组，分别插入LMA或气管内导管。采用标准化麻醉技术。然后比较两组在插入及拔除LMA和气管内导管时的血流动力学变化，并记录发生的任何并发症。
与气管内导管组相比，LMA组插入时的血流动力学反应明显减弱（p < 0.05）。两组拔管时的心血管反应无显著差异。与LMA组相比，气管内导管组拔管时咳嗽和轻度低氧血症的发生率更高（p < 0.05），拔除LMA后4例出现血性分泌物。
得出结论，在选定病例中，正压通气期间使用LMA是安全的。与气管内导管相比，插入LMA时的血流动力学反应减弱，这对某些患者有益，例如患有缺血性心脏病、血管疾病和高血压的患者。
