不同头颈部位置下LMA-ProSeal喉罩和标准喉罩气道的稳定性：一项随机交叉研究

Stability of the LMA-ProSeal and standard laryngeal mask airway in different head and neck positions: a randomized crossover study.

作者信息

Brimacombe J, Keller C

机构信息

University of Queensland James Cook University, Department of Anaesthesia and Intensive Care, Cairns Base Hospital, The Esplanade, Australia.

出版信息

Eur J Anaesthesiol. 2003 Jan;20(1):65-9. doi: 10.1017/s0265021503000127.

DOI:10.1017/s0265021503000127

PMID:12553391

Abstract

BACKGROUND AND OBJECTIVE

The LMA-ProSeal laryngeal mask airway is a new laryngeal mask airway with a modified cuff and drainage tube. We compared oropharyngeal leak pressure, intracuff pressure and anatomical position (assessed fibreoptically) for the Size 5 LMA-ProSeal laryngeal mask airway and the classic laryngeal mask airway in different head-neck positions and using different intracuff inflation volumes.

METHODS

Thirty paralysed anaesthetized adult male patients were studied. The LMA-ProSeal laryngeal mask airway and the classic laryngeal mask airway were inserted into each patient in random order. The oropharyngeal leak pressure, intracuff pressure, and anatomical position of the airway tube and drainage tube (LMA-ProSeal laryngeal mask airway only) were documented in four head and neck positions (neutral first, then flexion, extension and rotation in random order), and at 0-40 mL cuff volumes in the neutral position in 10 mL increments.

RESULTS

Compared with the neutral position, the oropharyngeal leak pressure for both the LMA-ProSeal laryngeal mask airway and the classic laryngeal mask airway was higher in flexion and rotation (all P < or = 0.02), but lower in extension (all P < or = 0.01). Changes in head-neck position did not alter the anatomical position of the airway tube or the drainage tube. The oropharyngeal leak pressure was always higher for the LMA-ProSeal laryngeal mask airway (all P < or = 0.005) and anatomical position better for the classic laryngeal mask airway (all P < or = 0.04).

CONCLUSIONS

The anatomical position of the LMA-ProSeal and the classic laryngeal mask airway is stable in different head-neck positions, but head-neck flexion and rotation are associated with an increase, and head-neck extension a decrease, in oropharyngeal leak pressure and intracuff pressure. The Size 5 LMA-ProSeal laryngeal mask airway is capable of forming a more effective seal than the Size 5 classic laryngeal mask airway in males.

摘要

背景与目的

LMA-ProSeal喉罩气道是一种带有改良套囊和引流管的新型喉罩气道。我们比较了5号LMA-ProSeal喉罩气道和传统喉罩气道在不同头颈部位置以及使用不同套囊充气量时的口咽漏气压、套囊内压力和解剖位置（通过纤维喉镜评估）。

方法

对30例成年男性麻醉瘫痪患者进行研究。将LMA-ProSeal喉罩气道和传统喉罩气道随机顺序插入每位患者。记录在四个头颈部位置（先中立位，然后随机顺序进行屈曲、伸展和旋转）以及中立位时套囊容积为0 - 40 mL（以10 mL递增）时的口咽漏气压、套囊内压力以及气道管和引流管（仅LMA-ProSeal喉罩气道）的解剖位置。

结果

与中立位相比，LMA-ProSeal喉罩气道和传统喉罩气道在屈曲和旋转时口咽漏气压均较高（所有P≤0.02），而在伸展时较低（所有P≤0.01）。头颈部位置的改变未改变气道管或引流管的解剖位置。LMA-ProSeal喉罩气道的口咽漏气压始终较高（所有P≤0.005），而传统喉罩气道的解剖位置更佳（所有P≤0.04）。