Ecoffey Claude, Auroy Yves, Pequignot Françoise, Jougla Eric, Clergue François, Laxenaire Marie-Claire, Lienhart André
Service d'Anesthésie-Réanimation Chirurgicale 2, Hôpital Pontchaillou, Université Rennes 1, Rennes, France.
Paediatr Anaesth. 2003 Sep;13(7):584-8. doi: 10.1046/j.1460-9592.2003.01106.x.
There are no epidemiological data describing tracheal intubation and laryngeal mask airway (LMATM) use in paediatric anaesthesia. This analysis focused on the factors leading to the indication for an airway management procedure, i.e. tracheal intubation and laryngeal mask airway vs face mask during general anaesthesia for tonsillectomy and appendicectomy.
The data were recorded in the French survey of Practical Anaesthesia performed in 1996. Two main types of surgical procedures were selected: tonsillectomy and appendicectomy because of the number of patients and the need to use an invasive airway management technique.
During a 1-year period, 627 anaesthetics for appendicectomy and 653 anaesthetics for tonsillectomy were recorded in the sample under consideration. Tracheal intubation or laryngeal mask airway was undertaken in 66% of tonsillectomies and 84% of appendicectomies. Univariate analysis showed that tracheal intubation/laryngeal mask were used significantly more often in older children, with long duration of anaesthesia, in nonambulatory procedures and in procedures performed at an academic centre. When these variables were included in a multivariate analysis, the duration of anaesthesia over 30 min was a factor linked to the use of tracheal intubation/laryngeal mask airway for the two types of surgery (P < 0.0001). For tonsillectomy, inpatients were 2.9 times more likely to be intubated (or have an laryngeal mask airway) than were outpatients. For appendicectomy, older children were 3.4 times more likely to be intubated (or have an laryngeal mask airway) than younger children.
This large French survey shows that the use of tracheal intubation/laryngeal mask airway in this country is primarily related to a predicted long duration of anaesthesia.
目前尚无关于小儿麻醉中气管插管和喉罩气道（LMA）使用情况的流行病学数据。本分析聚焦于导致气道管理操作指征的因素，即在扁桃体切除术和阑尾切除术全身麻醉期间气管插管、喉罩气道与面罩的使用情况。
数据记录于1996年进行的法国实用麻醉调查。由于患者数量以及使用侵入性气道管理技术的必要性，选择了两种主要的外科手术：扁桃体切除术和阑尾切除术。
在为期1年的时间里，在所考虑的样本中记录了627例阑尾切除术麻醉和653例扁桃体切除术麻醉。66%的扁桃体切除术和84%的阑尾切除术采用了气管插管或喉罩气道。单因素分析显示，年龄较大的儿童、麻醉时间较长、非门诊手术以及在学术中心进行的手术中，气管插管/喉罩的使用频率明显更高。当将这些变量纳入多因素分析时，麻醉时间超过30分钟是与两种手术中使用气管插管/喉罩气道相关的一个因素（P < 0.0001）。对于扁桃体切除术，住院患者插管（或使用喉罩气道）的可能性是门诊患者的2.9倍。对于阑尾切除术，年龄较大的儿童插管（或使用喉罩气道）的可能性是年龄较小儿童的3.4倍。
这项大型法国调查表明，该国气管插管/喉罩气道的使用主要与预计的麻醉时间较长有关。
