Sanders John C, Olomu Patrick N, Furman Joseph R
Department of Anesthesiology and Critical Care, University of New Mexico, School of Medicine, Albuquerque, NM, USA.
Paediatr Anaesth. 2008 Dec;18(12):1183-9. doi: 10.1111/j.1460-9592.2008.02784.x.
Our objective was to assess the use of several tests of ProSeal LMA (PLMA) position and function that had been previously published but not studied in the pediatric population in a wide variety of clinical cases.
The PLMA is widely used in pediatric anesthesia practice but complication rates have only been studied in small series while tests of function suggested for adults have not been studied at all.
We prospectively collected data, after placement of the PLMA by the digital method, on depth of insertion (DOI), 'suprasternal notch' test, 'chest pressure test', leak pressure, maximum minute ventilation (MMV), resting minute ventilation (RMV), success rate of insertion and success rate of passage of a gastric tube. Perioperative complication rates were recorded.
A total of 222 cases were analyzed, 47 were laparoscopic or open abdomen, 15 nonsupine. Ages were 2 months to 20 years and weight 5.4-116 kg. Two hundred seven (91%) were placed successfully at first attempt and 100% at third attempt. One hundred fifty-four of 156 (99%) gastric tubes were placed successfully. Four patients had signs of inadequate ventilation. All of these had MMV/RMV ratios <2. A total of nine had MMV/RMV ratio <2. Eight had DOI score < or =2.
The PLMA can be used in a large variety of cases with a high degree of success. Clinical tests described for adults, such as MMV/RMV ratio and DOI are also associated with complications in the pediatric population.
我们的目的是评估几种先前已发表但尚未在儿科人群的各种临床病例中进行研究的食管-胃联合导气管（PLMA）位置和功能测试。
PLMA在儿科麻醉实践中广泛使用，但并发症发生率仅在小样本中进行过研究，而针对成人建议的功能测试则根本未被研究过。
在通过数字方法放置PLMA后，我们前瞻性地收集了关于插入深度（DOI）、“胸骨上切迹”测试、“胸部按压测试”、漏气压力、最大分钟通气量（MMV）、静息分钟通气量（RMV）、插入成功率和胃管通过成功率的数据。记录围手术期并发症发生率。
共分析了222例病例，其中47例为腹腔镜或开腹手术，15例为非仰卧位。年龄为2个月至20岁，体重为5.4 - 116千克。207例（91%）首次尝试放置成功，第三次尝试时100%成功。156例中有154例（99%）胃管放置成功。4例患者有通气不足的迹象。所有这些患者的MMV/RMV比值均<2。共有9例患者的MMV/RMV比值<2。8例患者的DOI评分≤2。
PLMA可用于多种病例，成功率较高。针对成人描述的临床测试，如MMV/RMV比值和DOI，在儿科人群中也与并发症相关。
