Micaglio M, Bonato R, De Nardin M, Parotto M, Trevisanuto D, Zanardo V, Doglioni N, Ori C
Institute of Anesthesia and Intensive Care, Department of Pharmacology and Anesthesiology, School of Medicine, University of Padova, Via C. Battisti, 267, IT-35121 Padua, Italy.
Br J Anaesth. 2009 Aug;103(2):263-7. doi: 10.1093/bja/aep106. Epub 2009 May 19.
When compared with the Classic laryngeal mask airway (cLMA), the recently introduced ProSeal laryngeal mask airway (PLMA) has modified features to produce higher airway seal pressures and enable ventilation in circumstances where the cLMA might fail. The first neonatal size 1 PLMA recently became available. This study was designed to compare the effectiveness of the size 1 cLMA and PLMA during positive pressure ventilation in anesthetized neonates and infants.
Forty-six consecutive patients undergoing elective cardiac surgical procedures were randomized for initial airway management with the cLMA or PLMA. Insertion time (IT), number of placement attempts, ease of placement, quality of the initial airway, maximum tidal volume (TVmax), and airway pressure at which an audible leak in the mouth (P(leak)) occurred were collected. All data were recorded before performing tracheal intubations.
IT and success rate were similar for both LMAs. The initial quality of the airway was significantly better for the PLMA (P<0.05). TVmax and P(leak) were significantly higher for PLMA (77 vs 58 ml, P<0.02 and 29.8 vs 24.4 cm H2O, P<0.02). No adverse events were recorded during the study.
The size 1 PLMA forms a more effective seal than size 1 cLMA in neonates. This might allow the PLMA to be used in those newborn infants requiring high airway pressures for ventilation.
与经典喉罩气道(cLMA)相比,最近推出的食管引流型喉罩气道(PLMA)具有改良特征,可产生更高的气道密封压力,并能在cLMA可能失败的情况下实现通气。首个新生儿1号尺寸的PLMA最近已上市。本研究旨在比较1号尺寸的cLMA和PLMA在麻醉新生儿和婴儿正压通气期间的有效性。
46例接受择期心脏外科手术的连续患者被随机分为使用cLMA或PLMA进行初始气道管理。收集插入时间(IT)、放置尝试次数、放置难易程度、初始气道质量、最大潮气量(TVmax)以及口腔出现可闻及漏气时的气道压力(P(leak))。所有数据均在进行气管插管前记录。
两种喉罩的IT和成功率相似。PLMA的初始气道质量明显更好(P<0.05)。PLMA的TVmax和P(leak)明显更高(分别为77 vs 58 ml,P<0.02;29.8 vs 24.4 cm H2O,P<0.02)。研究期间未记录到不良事件。
在新生儿中,1号尺寸的PLMA比1号尺寸的cLMA形成的密封更有效。这可能使PLMA可用于那些需要高气道压力进行通气的新生儿。