Hohlrieder M, Brimacombe J, von Goedecke A, Keller C
Department of Anaesthesia and Intensive Care Medicine, Medical University Innsbruck, Austria.
Br J Anaesth. 2007 Oct;99(4):576-80. doi: 10.1093/bja/aem096. Epub 2007 Jul 6.
We test the hypothesis that the frequency of postoperative nausea and vomiting is similar for the ProSeal laryngeal mask airway (LMA) and the tracheal tube.
Two hundred consecutive female patients (ASA I-II, 18-75 yr) undergoing routine breast and gynaecological surgery were divided into two equal-sized groups for airway management with the ProSeal LMA or tracheal tube.
Ventilation was better and airway trauma less frequent for the ProSeal LMA. For the ProSeal group, the time spent in the post-anaesthesia care unit was shorter (69 vs 88 min, P < 0.0001); fewer doses of tropisetron were required in the post-anaesthesia care unit (P < or = 0.001) and ward (P = 0.004); morphine requirements were lower in the post-anaesthesia care unit (6.0 vs 8.1 mg, P = 0.005) and ward (6.1 vs 8.9, P = 0.004); nausea was less frequent at all times (overall: 13% vs 53%, P < 0.0001); vomiting was less frequent at 2 h (4% vs 18%, P = 0.003) and 24 h (5% vs 19%, P = 0.004); and sore throat was less frequent at all times (overall: 12% vs 38%, P < 0.0001).
The ProSeal LMA reduced the absolute risk of postoperative nausea and vomiting by 40% (53-13%). In patients without the need for morphine, the ProSeal LMA reduced the absolute risk of postoperative nausea and vomiting by 23% (37-14%). We conclude that the frequency of postoperative nausea, vomiting, airway morbidity, and analgesic requirements is lower for the ProSeal LMA than the tracheal tube in females undergoing breast and gynaecological surgery.
我们检验了一个假设，即对于食管引流型喉罩气道（LMA）和气管导管而言，术后恶心呕吐的发生率相似。
连续200例接受常规乳腺和妇科手术的女性患者（美国麻醉医师协会分级I-II级，18 - 75岁）被分为两组，每组人数相等，分别采用食管引流型喉罩气道或气管导管进行气道管理。
食管引流型喉罩气道的通气效果更好，气道创伤发生率更低。对于使用食管引流型喉罩气道的组，在麻醉后恢复室停留的时间更短（69分钟对88分钟，P < 0.0001）；在麻醉后恢复室（P ≤ 0.001）和病房（P = 0.004）所需的托烷司琼剂量更少；在麻醉后恢复室（6.0毫克对8.1毫克，P = 0.005）和病房（6.1对8.9，P = 0.004）所需的吗啡剂量更低；恶心在各个时间点的发生率都更低（总体：13%对53%，P < 0.0001）；呕吐在2小时（4%对18%，P = 0.003）和24小时（5%对19%，P = 0.004）时的发生率更低；咽痛在各个时间点的发生率都更低（总体：12%对38%，P < 0.0001）。
食管引流型喉罩气道使术后恶心呕吐的绝对风险降低了40%（53% - 13%）。在不需要吗啡的患者中，食管引流型喉罩气道使术后恶心呕吐的绝对风险降低了23%（37% - 14%）。我们得出结论，对于接受乳腺和妇科手术的女性患者，食管引流型喉罩气道术后恶心、呕吐、气道并发症及镇痛需求的发生率低于气管导管。
