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喉罩气道在耳科手术中的应用。

Laryngeal mask airway use in otologic surgery.

作者信息

Ayala Marco Antonio, Sanderson Alicia, Marks Robert, Hoffer Michael, Balough Ben

机构信息

Otolaryngology-Head and Neck Surgery Department, Naval Medical Center San Diego, San Diego, California 92134-1005, USA.

出版信息

Otol Neurotol. 2009 Aug;30(5):599-601. doi: 10.1097/MAO.0b013e3181ab8de2.

Abstract

OBJECTIVE

The purpose of this study was to evaluate the safety and efficacy of the laryngeal mask airway (LMA) compared with oral endotracheal tube (ETT) in general anesthesia in patients who underwent otologic surgery.

STUDY DESIGN

Retrospective review.

SETTING

Military tertiary care teaching hospital.

PATIENTS

A retrospective chart review study was conducted on 484 patients who underwent otologic surgery at a large military tertiary care teaching hospital from January 2002 to August 2005. A review of otologic surgical cases using the LMA (n = 167) was compared to a similar cohort managed with an oral ETT (n = 317).

MAIN OUTCOME MEASURES

The patient's age, weight, indication for surgery, comorbid conditions, American Society of Anesthesiologists classification, duration of surgery, and adverse events were recorded. Specific data reviewed included airway complications, intraoperative times, anesthetic medications, postoperative nausea and vomiting, and time spent in the postanesthesia care unit.

RESULTS

There were no major airway complications in either group requiring an emergency airway. A significant decreased use of neuromuscular blocking agents was noted in the LMA group. Statistical analysis of variances was performed using 2-sample Wilcoxon rank-sum (Mann-Whitney U) test and Fisher's exact test. The time in the operating room to the start of surgery and the time from completion of surgery to patient exiting the operating room were shorter for the LMA group than for the ETT group. There were no statistical differences in postanesthesia care unit time or postoperative nausea and vomiting.

CONCLUSION

The LMA offers a safe alternative in children and adults to endotracheal intubation with no observed increased risk of airway complications in patients undergoing otologic surgery.

摘要

目的

本研究旨在评估在接受耳科手术的患者全身麻醉中,喉罩气道(LMA)与气管内插管(ETT)相比的安全性和有效性。

研究设计

回顾性研究。

研究地点

军队三级护理教学医院。

患者

对2002年1月至2005年8月在一家大型军队三级护理教学医院接受耳科手术的484例患者进行回顾性病历研究。将使用LMA的耳科手术病例(n = 167)与使用气管内ETT管理的类似队列(n = 317)进行比较。

主要观察指标

记录患者的年龄、体重、手术指征、合并症、美国麻醉医师协会分级、手术时间和不良事件。审查的具体数据包括气道并发症、术中时间、麻醉药物、术后恶心和呕吐以及在麻醉后护理单元的停留时间。

结果

两组均未出现需要紧急气道处理的重大气道并发症。LMA组神经肌肉阻滞剂的使用显著减少。使用双样本Wilcoxon秩和(Mann-Whitney U)检验和Fisher精确检验进行方差统计分析。LMA组从进入手术室到开始手术的时间以及从手术结束到患者离开手术室的时间比ETT组短。麻醉后护理单元时间或术后恶心和呕吐方面无统计学差异。

结论

对于儿童和成人,LMA是气管内插管的一种安全替代方法,在接受耳科手术的患者中未观察到气道并发症风险增加。

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