Goldmann Kai, Jakob Christian
Department of Anaesthesia and Intensive Care Therapy, Philipps University Marburg, Germany.
Anesth Analg. 2005 Jun;100(6):1605-1610. doi: 10.1213/01.ANE.0000152640.25078.90.
The laryngeal mask airway (LMA)-ProSeal (P-LMA) forms a more effective seal than the LMA-Classic (C-LMA) and facilitates gastric tube (g-tube) placement in adults. The first pediatric sizes of P-LMA recently became available. In 30 anesthetized, nonparalyzed children, aged 7.7 +/- 2 yr and weighing 27 (20-35) kg, we inserted the size (1/2) P-LMA and C-LMA in random order. Ease of insertion, quality of initial airway, fiberoptic position, airway leak pressure, and maximum tidal volume were determined. G-tube placement was assessed for the P-LMA. Ease of insertion was similar for both devices. The quality of the initial airway was better for the P-LMA (P = 0.01). Airway leak pressure in neutral head position (22.6 versus 18.5 mbar; P = 0.003), maximum flexion (37 versus 26.3 mbar; P < 0.001), maximum extension (15.2 versus 13 mbar; P = 0.045), and maximum tidal volume (1088 versus 949 mL; P = 0.002) were significantly better for the P-LMA. Air entry into the stomach occurred with the C-LMA but not with the P-LMA (P = 0.014). G-tube placement was possible in all patients. The reliability of g-tube placement and the significantly increased airway leak pressure found in this investigation might have important implications for use of the size (1/2) P-LMA for positive pressure ventilation in children.
喉罩气道（LMA）-ProSeal（P-LMA）比LMA-Classic（C-LMA）能形成更有效的密封，且便于在成人中放置胃管（g管）。P-LMA的首批儿科尺寸最近已上市。在30名年龄为7.7±2岁、体重27（20 - 35）kg的麻醉、未麻痹儿童中，我们随机顺序插入尺寸为（1/2）的P-LMA和C-LMA。测定了插入的难易程度、初始气道质量、纤维光学位置、气道泄漏压力和最大潮气量。对P-LMA评估了g管放置情况。两种装置插入的难易程度相似。P-LMA的初始气道质量更好（P = 0.01）。在中立头位时，P-LMA的气道泄漏压力（22.6对18.5毫巴；P = 0.003）、最大屈曲时（37对26.3毫巴；P < 0.001）、最大伸展时（15.2对13毫巴；P = 0.045）以及最大潮气量（1088对949毫升；P = 0.002）均显著更好。C-LMA时空气会进入胃内，而P-LMA则不会（P = 0.014）。所有患者均可行g管放置。本研究中发现的g管放置的可靠性以及气道泄漏压力的显著增加可能对尺寸为（1/2）的P-LMA在儿童正压通气中的使用具有重要意义。
