Zand F, Amini A, Sadeghi S E, Gureishi M, Chohedri A
Shiraz University of Medical Sciences, Namazi Hospital, Department of Anaesthesiology, Shiraz, Iran.
Eur J Anaesthesiol. 2007 Oct;24(10):847-51. doi: 10.1017/S0265021507000804. Epub 2007 Jul 3.
The Laryngeal Tube Sonda (LTS) and the ProSeal Laryngeal Mask Airway (PLMA) are two new devices introduced for maintaining the airway during controlled ventilation under general anaesthesia. The present investigation compared their performance in a randomized controlled study.
One hundred ASA I-II patients, aged 18-60 yr undergoing elective minor surgery, were randomized to receive either an LTS (n = 50) or PLMA (n = 50) for airway management. After induction of general anaesthesia, the devices were inserted, its correct placement was verified and airway leak pressure was measured. Ease of insertion, quality of airway seal, fibre-optic view and postoperative pharyngeal morbidity were examined.
There were no differences in patient characteristics for both groups. First-time and second-time success rates were comparable for both groups (86 vs. 88% and 96 vs. 98% in LTS and PLMA groups, respectively). The airway of one patient in each group could not be managed with these devices after three attempts. Time until delivery of first tidal volume for LTS and PLMA was 24.5 +/- 6.9 and 28.8 +/- 10.3 s. Fixation and manipulation time was 54.9 +/- 15.2 and 73.2 +/- 25 s, respectively (P < 0.05). Airway seal pressure (cm H(2)O) for LTS and PLMA was 20 +/- 8.6 and 24.1 +/- 10.8, respectively (P = 0.04). Patients were questioned on a variety of postoperative pharyngeal morbidities. Only hoarseness was more frequent in the LTS group.
Both devices provide a secure airway, are similar in clinical utility and are easy to insert. Better airway seal was detected in the PLMA group.
喉管探条(LTS)和食管引流型喉罩通气道(PLMA)是在全身麻醉控制通气期间用于维持气道的两种新装置。本研究在一项随机对照研究中比较了它们的性能。
100例年龄在18至60岁、接受择期小手术的美国麻醉医师协会(ASA)I-II级患者,被随机分为接受LTS(n = 50)或PLMA(n = 50)进行气道管理。全身麻醉诱导后,插入装置,确认其正确放置并测量气道漏气压力。检查插入的难易程度、气道密封质量、纤维喉镜视野及术后咽部并发症。
两组患者的特征无差异。两组的首次和二次成功率相当(LTS组和PLMA组分别为86%对88%和96%对98%)。每组各有1例患者在三次尝试后无法用这些装置管理气道。LTS和PLMA输送首次潮气量的时间分别为24.5±6.9秒和28.8±10.3秒。固定和操作时间分别为54.9±15.2秒和73.2±25秒(P<0.05)。LTS和PLMA的气道密封压力(厘米水柱)分别为20±8.6和24.1±10.8(P = 0.04)。询问患者各种术后咽部并发症情况。仅LTS组的声音嘶哑更常见。
两种装置均能提供安全的气道,临床效用相似且易于插入。PLMA组检测到更好的气道密封。