新型喉罩吸引器LTS II与LMA-ProSeal用于择期手术干预的前瞻性随机对照研究。

Prospective randomized comparison of the new Laryngeal Tube Suction LTS II and the LMA-ProSeal for elective surgical interventions.

作者信息

Genzwuerker H V, Altmayer S, Hinkelbein J, Gernoth C, Viergutz T, Ocker H

机构信息

Clinic of Anaesthesiology and Intensive Care Medicine, University Hospital Mannheim, Manheim, Germany.

出版信息

Acta Anaesthesiol Scand. 2007 Nov;51(10):1373-7. doi: 10.1111/j.1399-6576.2007.01440.x.

DOI:10.1111/j.1399-6576.2007.01440.x

PMID:17944641

Abstract

BACKGROUND AND AIM

The Laryngeal Tube Suction (LTS) has recently undergone considerable changes in design. The new LTS II was compared with the LMA-ProSeal to determine device performance during general anaesthesia and controlled ventilation.

METHODS

After Institutional Review Board approval, 100 elective surgical patients were randomized to be ventilated with LTS II or LMA-ProSeal. The number of attempts (maximum of two, and then other device tested) and time until first tidal volume were recorded. Ventilation was standardized (tidal volume, 7 ml/kg; respiratory rate, 12 breaths/min) and the resulting end-tidal CO(2) was recorded. The airway leak pressure (maximum of 40 cmH(2)O) was measured at cuff pressures of 60 cmH(2)O. The ease of gastric tube insertion was evaluated. The devices were inspected for traces of blood after removal. Patients were questioned regarding post-operative complaints. The Mann-Whitney U-test was used to compare the groups.

RESULTS

The demographic data, American Society of Anesthesiologists' group, Mallampati score, and haemodynamic and respiratory variables were comparable for both groups of 50 patients. Insertion was successful in the first/second attempts in 44/4 patients for LTS II and in 43/6 patients for LMA-ProSeal. After two failed attempts, the other device was successfully used in one patient for LMA-ProSeal and in two patients for LTS II. The times until first tidal volume for LTS II and LMA-ProSeal were 25.0 +/- 10.1 and 25.5 +/- 11.5 s, respectively. The airway leak pressures were comparable: 33.1 (15-40) and 32.0 cmH(2)O (18-40 cmH(2)O) for LTS II and LMA-ProSeal, respectively. Gastric tube insertion failed in two patients in each group. Traces of blood were found in two patients with LTS II and in three patients with LMA-ProSeal. In both groups, post-operative complaints were mild and infrequent.

CONCLUSION

In this prospective randomized trial, LMA-ProSeal and LTS II were comparable in all respects.

摘要

背景与目的

喉罩吸引通气道（LTS）最近在设计上有了相当大的改变。将新型LTS II与食管引流型喉罩（LMA-ProSeal）进行比较，以确定在全身麻醉和控制通气期间的设备性能。

方法

经机构审查委员会批准后，100例择期手术患者被随机分为使用LTS II或LMA-ProSeal进行通气。记录尝试次数（最多两次，然后测试其他设备）和直至出现首次潮气量的时间。通气标准化（潮气量，7 ml/kg；呼吸频率，12次/分钟），并记录由此产生的呼气末二氧化碳分压。在袖带压力为60 cmH₂O时测量气道漏气压力（最大40 cmH₂O）。评估胃管插入的难易程度。取出设备后检查是否有血迹。询问患者术后的不适情况。采用曼-惠特尼U检验对两组进行比较。

结果

两组各50例患者的人口统计学数据、美国麻醉医师协会分级、马兰帕蒂评分以及血流动力学和呼吸变量具有可比性。LTS II组44/4例患者在首次/第二次尝试时插入成功，LMA-ProSeal组43/6例患者插入成功。两次尝试失败后，LMA-ProSeal组有1例患者成功使用了另一种设备，LTS II组有2例患者成功使用了另一种设备。LTS II和LMA-ProSeal出现首次潮气量的时间分别为25.0±10.1秒和25.5±11.5秒。气道漏气压力具有可比性：LTS II和LMA-ProSeal分别为33.1（15 - 40）cmH₂O和32.0 cmH₂O（18 - 40 cmH₂O）。每组各有2例患者胃管插入失败。LTS II组有2例患者、LMA-ProSeal组有3例患者发现有血迹。两组患者术后的不适症状均较轻且不常见。