Mizutamari Etsuko, Yano Toshiyuki, Ushijima Kazuo, Ito Asuka, Anraku Sakiko, Tanimoto Hironari, Terasaki Hidenori
Department of Anesthesiology and Surgical Center, Kumamoto University Hospital, 1-1-1 Honjo, 860-8556 Kumamoto, Japan.
J Anesth. 2004;18(3):151-7. doi: 10.1007/s00540-004-0234-8.
We compared the degree of postoperative sore throat (PST) after use of a laryngeal mask airway (LMA; by two insertion techniques) and a tracheal tube (TT) in adult patients.
Eighty-six adult patients undergoing surgery of an extremity were randomized into three groups. The LMAs (size 4 for men, 3 for women) and TTs were lubricated with 2% lidocaine gel. After the induction of anesthesia, an LMA with the cuff deflated was inserted and then the cuff was inflated in group A, an LMA with the cuff inflated was inserted in group B, and the trachea was intubated using vecuronium in group C; staff anesthesiologists performed all these methods. LMA cuffs were inflated with the maximum recommended volume of air. TT cuffs were inflated with the minimum volume of air without gas leakage at 20 cm H(2)O pressure. The mode of ventilation depended on the individual anesthesiologists. Blood traces on the devices were examined after their removal. PST was rated immediately after anesthesia and on the first postoperative day, using a three-point score and a 100-mm visual analog scale, respectively.
Most of the patients receiving an LMA breathed spontaneously and those receiving a TT underwent controlled ventilation. The ratio of positive blood traces on devices, as well as the degree of PST immediately after anesthesia, was similar in the three groups; however, on the first postoperative day, the severity of PST was greater in the LMA groups than in the TT group ( P = 0.016). The severity of PST was similar with the two LMA insertion techniques.
In the conditions of our study, LMAs inserted with the cuff either fully inflated or deflated worsened PST compared with TTs.
我们比较了成年患者使用喉罩气道(LMA;采用两种插入技术)和气管导管(TT)后术后咽痛(PST)的程度。
86例接受肢体手术的成年患者被随机分为三组。LMA(男性用4号,女性用3号)和TT均用2%利多卡因凝胶润滑。麻醉诱导后,A组插入袖带放气的LMA,然后给袖带充气;B组插入袖带充气的LMA;C组使用维库溴铵进行气管插管;所有这些操作均由专业麻醉医师进行。LMA袖带充入最大推荐气量。TT袖带充入最小气量,在20 cm H₂O压力下无气体泄漏。通气模式取决于个体麻醉医师。器械移除后检查其上的血迹。分别在麻醉后即刻和术后第一天使用三分制评分和100 mm视觉模拟量表对PST进行评分。
大多数接受LMA的患者自主呼吸,而接受TT的患者进行控制通气。三组器械上阳性血迹的比例以及麻醉后即刻的PST程度相似;然而,在术后第一天,LMA组的PST严重程度高于TT组(P = 0.016)。两种LMA插入技术的PST严重程度相似。
在我们的研究条件下,与TT相比,袖带完全充气或放气插入的LMA会加重PST。