Shimbori H, Ono K, Miwa T, Morimura N, Noguchi M, Hiroki K
Department of Anaesthesia, Kanagawa Children's Medical Centre, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan.
Br J Anaesth. 2004 Oct;93(4):528-31. doi: 10.1093/bja/aeh238. Epub 2004 Aug 6.
The LMA-ProSeal is a new laryngeal mask airway with a rear cuff and drainage tube that allows a higher seal pressure than the LMA-Classic for the same intra-cuff pressure, and it permits drainage of gastric secretions and access to the alimentary tract. The LMA-ProSeal can be used in children but it does not have a rear cuff. This study compared the LMA-ProSeal and the LMA-Classic in children for ease of insertion, airway sealing pressure and fibre-optic visualization.
Sixty ASA I-II children undergoing herniorrhaphy, orchiopexy or myringotomy were included. The patients were randomly assigned to size 2 LMA-Classic trade mark or size 2 LMA-ProSeal groups for airway management. We assessed success rates at first attempt of insertion, airway sealing pressure, fibre-optic position, success rates of gastric tube placement and postoperative blood staining of the device, tongue-lip-dental trauma and hoarseness.
There was no statistical difference between the two groups for the success rates at first attempt of insertion, airway sealing pressure and fibre-optic position. Gastric tube insertion was successful in 90% of cases in the LMA-ProSeal group. The LMA-Classic had a higher rate of postoperative blood staining, but there was no tongue-lip-dental trauma or hoarseness in either group.
We conclude that ease of insertion and airway sealing pressure are similar between the LMA-ProSeal and the LMA-Classic in children.
LMA-ProSeal是一种新型喉罩气道,带有后置套囊和引流管,在相同套囊内压下,其密封压力高于LMA-Classic,并且允许引流胃分泌物以及进入消化道。LMA-ProSeal可用于儿童,但没有后置套囊。本研究比较了LMA-ProSeal和LMA-Classic在儿童中的插入难易程度、气道密封压力和纤维光学可视性。
纳入60例接受疝修补术、睾丸固定术或鼓膜切开术的美国麻醉医师协会(ASA)分级为I-II级的儿童。将患者随机分配至使用2号LMA-Classic商标或2号LMA-ProSeal进行气道管理的组。我们评估了首次插入成功率、气道密封压力、纤维光学位置、胃管置入成功率、术后器械血染情况、舌唇齿创伤和声音嘶哑情况。
两组在首次插入成功率、气道密封压力和纤维光学位置方面无统计学差异。LMA-ProSeal组90%的病例胃管置入成功。LMA-Classic术后血染发生率较高,但两组均无舌唇齿创伤或声音嘶哑。
我们得出结论,LMA-ProSeal和LMA-Classic在儿童中的插入难易程度和气道密封压力相似。