Kihara Shinichi, Brimacombe Joseph
Department of Anaesthesia, Pain Clinic, Ibaraki, Japan.
Anesth Analg. 2003 Jul;97(1):280-4, table of contents. doi: 10.1213/01.ane.0000068824.86773.b0.
We compared the Size 4 and 5 ProSeal laryngeal mask airway (PLMA) in men and the Size 3 and 4, and 4 and 5 PLMA in women in terms of 1) ease of insertion, 2) oropharyngeal leak pressure (OLP), 3) ease of ventilation at a tidal volume of 10 mL/kg, 4) gas exchange, 5) location of gas leak, 6) anatomic position of the airway and drain tube, and 7) mucosal injury. Thirty male and 60 female (ASA physical status I-II; 18-80 yr old) anesthetized, paralyzed patients were studied in a crossover fashion in three equal-sized groups. PLMA insertion was performed by a single experienced operator by using digital manipulation. In male patients comparing the Size 4 and 5, OLP was higher (P = 0.0002) and leak fraction lower (P = 0.03) for the Size 5, but the number of insertion attempts, insertion time, mucosal injury, anatomic position, gas exchange, and location of gas leak were similar. In female patients comparing the Size 4 and 5 PLMA, OLP was higher for the Size 5 (P < 0.0001), but the number of insertion attempts was fewer (P = 0.02), insertion time was quicker (P = 0.02), and there was less mucosal injury (P = 0.01) with the Size 4. There were no differences in anatomic position, gas exchange, or location of gas leak. In female patients comparing the Size 3 and 4 PLMA, OLP was higher (P = 0.0005) and leak fraction was lower (P = 0.03) for the Size 4, but the number of insertion attempts, insertion time, mucosal injury, anatomic position, gas exchange, and location of gas leak were similar. There were no episodes of failed oxygenation, failed ventilation, or gastric insufflation. We conclude that if size is selected by sex, the Size 4 PLMA is preferable for women and the Size 5 PLMA for men.
When sex is used to select the appropriate size of the ProSeal laryngeal mask airway, the Size 4 ProSeal is preferable for women and the Size 5 ProSeal for men.
我们比较了男性使用的4号和5号普罗塞尔喉罩气道（PLMA）以及女性使用的3号和4号、4号和5号PLMA，比较内容包括：1）插入的难易程度；2）口咽漏气压（OLP）；3）潮气量为10 mL/kg时通气的难易程度；4）气体交换；5）漏气位置；6）气道和引流管的解剖位置；7）黏膜损伤。30名男性和60名女性（美国麻醉医师协会身体状况分级I-II级；年龄18 - 80岁）接受麻醉、肌肉松弛的患者以交叉方式在三个同等规模的组中进行研究。PLMA的插入由一名经验丰富的操作人员通过手指操作完成。在男性患者中比较4号和5号PLMA，5号的OLP更高（P = 0.0002），漏气率更低（P = 0.03），但插入尝试次数、插入时间、黏膜损伤、解剖位置、气体交换和漏气位置相似。在女性患者中比较4号和5号PLMA，5号的OLP更高（P < 0.0001），但4号的插入尝试次数更少（P = 0.02），插入时间更快（P = 0.02），且黏膜损伤更少（P = 0.01）。解剖位置、气体交换或漏气位置没有差异。在女性患者中比较3号和4号PLMA，4号的OLP更高（P = 0.0005），漏气率更低（P = 0.03），但插入尝试次数、插入时间、黏膜损伤、解剖位置、气体交换和漏气位置相似。没有出现氧合失败、通气失败或胃充气的情况。我们得出结论，如果根据性别选择尺寸，4号PLMA对女性更合适，5号PLMA对男性更合适。
当根据性别选择合适尺寸的普罗塞尔喉罩气道时，4号普罗塞尔喉罩对女性更合适，5号普罗塞尔喉罩对男性更合适。
