Francksen H, Bein B, Cavus E, Renner J, Scholz J, Steinfath M, Tonner P H, Doerges V
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Schwanenweg 21, D-24105 Kiel, Germany.
Eur J Anaesthesiol. 2007 Feb;24(2):134-40. doi: 10.1017/S0265021506001219. Epub 2006 Aug 8.
This study was performed to compare three disposable airway devices, the LMA Unique (LMA-U), the Ambu laryngeal mask (Ambu LM) and the Soft Seal laryngeal mask (Soft Seal LM) for elective general anaesthesia during controlled ventilation in non-paralysed patients.
One hundred and twenty ASA I-III patients scheduled for routine minor obstetric surgery were randomly allocated to the LMA-U (n = 40), Ambu LM (n = 40) or Soft Seal LM (n = 40) groups, respectively. Patients were comparable with respect to weight and airway characteristics. A size 4 LMA was used in all patients and inserted by a single experienced anaesthesiologist. Oxygenation, overall success rate, insertion time, cuff pressure and resulting airway leak pressure were determined as well as a subjective assessment of handling and the incidence of sore throat, dysphagia and hoarseness.
Time of insertion was shortest with the Ambu LM, while failure rates were comparable with the LMA-U, the Ambu LM and the Soft Seal LM (median 19 s; range 8-57 s; success rate 100% vs. 14; 8-35; 97% vs. 20; 12-46; 95%). Insertion was judged 'excellent' in 75% of patients in the LMA-U group, in 70% of patients in Ambu LM group and in 65% of patients in the Soft Seal LM group. There was no difference between devices with respect to postoperative airway morbidity at 6 h or 24 h following surgery.
All three disposable devices were clinically suitable with respect to insertion times, success rates, oxygenation, airway and leak pressures, as well as to subjective handling and postoperative airway morbidity.
本研究旨在比较三种一次性气道装置,即LMA Unique(LMA-U)、Ambu喉罩(Ambu LM)和Soft Seal喉罩(Soft Seal LM),用于非瘫痪患者在控制通气下的择期全身麻醉。
120例计划行常规小型产科手术的ASA I-III级患者,分别随机分配至LMA-U组(n = 40)、Ambu LM组(n = 40)或Soft Seal LM组(n = 40)。患者在体重和气道特征方面具有可比性。所有患者均使用4号LMA,由一名经验丰富的麻醉医生插入。测定氧合、总体成功率、插入时间、套囊压力和气道漏气压力,并对操作进行主观评估,以及咽痛、吞咽困难和声音嘶哑的发生率。
Ambu LM的插入时间最短,而LMA-U、Ambu LM和Soft Seal LM的失败率相当(中位数19秒;范围8 - 57秒;成功率分别为100%对14;8 - 35;97%对20;12 - 46;95%)。LMA-U组75%的患者、Ambu LM组70%的患者和Soft Seal LM组65%的患者插入情况被判定为“优秀”。术后6小时或24小时,各装置在气道并发症方面无差异。
就插入时间、成功率、氧合、气道和漏气压力以及主观操作和术后气道并发症而言,这三种一次性装置在临床上均适用。