Heuer J F, Stiller M, Rathgeber J, Eich C, Züchner K, Bauer M, Timmermann A
Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Universitätsmedizin Göttingen, Göttingen.
Anaesthesist. 2009 Aug;58(8):813-20. doi: 10.1007/s00101-009-1600-6.
Supraglottic airway devices (SGAD) have become more important in airway management over the past years and an objective comparison of the available devices is in order.
In a prospective study the four SGADs LMA-Classic(cLMA), LMA-ProSeal (PLMA), Ambu AuraOnce and Intersurgical i-gel were compared in groups of 40 patients in ambulatory surgery, with respect to the feasibility of positioning, leak tightness, patient comfort and airway morbidity. The seal test of the airway devices was carried out with a specially constructed pneumotachograph.
Adequate placement on the first attempt was achieved in 92.5% with the cLMA, 85% with the PLMA, 92.5% with the AuraOnce and 82.5% with the i-gel (p>0.05). There were no clinically relevant differences in mean insertion times: cLMA 13.8 s (+/-3.4 s), PLMA 13 s (+/-3.2 s), AuraOnce 11.2 s (+/-2.7 s; p<0.05) and 13.9 s (+/-3.6 s) with the i-gel. A tight seal at a constant oropharyngeal pressure of 15 cmH(2)O was achieved in 85% of the cases (34 cases) with the cLMA, 90% (36 cases) with the PLMA, 97.5% (39 cases) with the AuraOnce and 72.5% (29 cases) with the i-gel (p<0.05). A tight seal at a constant oropharyngeal pressure of 20 cmH(2)O was seen in 62.5% with the cLMA, 60% with the PLMA, 67.5% with the AuraOnce and in 50% with the i-gel of the cases (p>0.05). Airway morbidity was not observed in any group. Significantly more patients complained of a sore throat after using the cLMA (p<0.05).
The tested SGADs were comparable with regard to ease of insertion, insertion times and airway morbidity. Considering leak tightness and patient comfort the PLMA and the AuraOnce fared better with regard to tightness of seal and patient comfort.
在过去几年中，声门上气道装置（SGAD）在气道管理中变得愈发重要，因此有必要对现有装置进行客观比较。
在一项前瞻性研究中，将四种SGAD（LMA-Classic（cLMA）、LMA-ProSeal（PLMA）、Ambu AuraOnce和Intersurgical i-gel）在40例门诊手术患者组中进行比较，比较内容包括放置的可行性、密封性、患者舒适度和气道并发症。气道装置的密封测试使用专门构建的呼吸流速仪进行。
首次尝试时，cLMA的放置成功率为92.5%，PLMA为85%，AuraOnce为92.5%，i-gel为82.5%（p>0.05）。平均插入时间无临床相关差异：cLMA为13.8秒（±3.4秒），PLMA为13秒（±3.2秒），AuraOnce为11.2秒（±2.7秒；p<0.05），i-gel为13.9秒（±3.6秒）。在口咽压力恒定为15 cmH₂O时，cLMA有85%的病例（34例）实现了紧密密封，PLMA为90%（36例），AuraOnce为97.5%（39例），i-gel为72.5%（29例）（p<0.05）。在口咽压力恒定为20 cmH₂O时，cLMA有62.5%的病例、PLMA有60%的病例、AuraOnce有67.5%的病例以及i-gel有50%的病例实现了紧密密封（p>0.05）。任何组均未观察到气道并发症。使用cLMA后抱怨喉咙痛的患者明显更多（p<0.05）。
在插入的难易程度、插入时间和气道并发症方面，所测试的SGAD具有可比性。考虑到密封性和患者舒适度，PLMA和AuraOnce在密封紧密性和患者舒适度方面表现更好。
