Klaver N S, Kuizenga K, Ballast A, Fidler V
Department of Anaesthesiology, Westfriesgasthuis, Postbox 600, 1620 AR Hoorn, The Netherlands.
Anaesthesia. 2007 Jul;62(7):723-7. doi: 10.1111/j.1365-2044.2007.05073.x.
The Laryngeal Tube S and the LMA-ProSeal are supraglottic instruments with an improved airway seal and a drainage tube to protect against regurgitation and to facilitate passage of a gastric tube. We compared the feasibility of these two instruments in a randomised, controlled clinical trial. One hundred and sixty patients were randomly allocated to undergo insertion of a Laryngeal Tube S (n = 82) or an LMA-ProSeal (n = 78). All insertions were carried out by first-month anaesthesia residents. Success rates were not significantly different: Laryngeal Tube S 89%, LMA-ProSeal 95%. There was also no significant difference in leak pressure or insertion time. Insertion time decreased significantly when we compared the first with the last 10 insertions. Gastric tube placement was successful in all patients in the Laryngeal Tube S group, but failed in 12 patients in the LMA-ProSeal group (p < 0.001). Dysphagia was reported by 22% of Laryngeal Tube S group and 3% of LMA-ProSeal group (p = 0.001). These findings demonstrate the applicability of the devices and a learning effect in the hands of anaesthesia residents with limited experience.
喉罩S型（Laryngeal Tube S）和食管引流型喉罩（LMA-ProSeal）是声门上气道装置，具有更好的气道密封效果和一根引流管，可防止反流并便于插入胃管。我们在一项随机对照临床试验中比较了这两种装置的可行性。160例患者被随机分配接受喉罩S型插入术（n = 82）或食管引流型喉罩插入术（n = 78）。所有插入操作均由入职首月的麻醉住院医师进行。成功率无显著差异：喉罩S型为89%，食管引流型喉罩为95%。漏气压或插入时间也无显著差异。当我们比较前10次和后10次插入操作时，插入时间显著缩短。喉罩S型组所有患者胃管置入均成功，但食管引流型喉罩组有12例患者失败（p < 0.001）。喉罩S型组22%的患者和食管引流型喉罩组3%的患者报告有吞咽困难（p = 0.001）。这些发现证明了这些装置的适用性以及经验有限的麻醉住院医师存在学习效应。
