Fernández Díez A, Pérez Villafañe A, Bermejo González J C, Marcos Vidal J M
Servicio de Anestesiología y Reanimación, Hospital de León.
Rev Esp Anestesiol Reanim. 2009 Oct;56(8):474-8. doi: 10.1016/s0034-9356(09)70437-2.
The Supreme Laryngeal Mask Airway (SLMA) and the I-gel Supraglottic Airway (IGSA) are recently introduced devices incorporating a gastric channel. This study assessed the ease of insertion of the devices and their efficacy in mechanical ventilation.
Eighty-five patients undergoing major outpatient surgery under general anesthesia were randomized to 2 groups for intubation using the SLMA or the IGSA. After induction of general anesthesia, the assigned mask was inserted and positioning was checked with a fiberoptic scope. Ease of insertion was evaluated. Seal pressure was measured and the following ventilatory parameters were recorded 10, 30, and 60 minutes after the start of surgery: peak pressure, mean pressure, compliance, and the ratio of tidal volume to respiratory frequency. Conditions at the moment of inserting the nasogastric tube were also noted.
First-attempt placement of the airway was possible in 95.2% of patients using the SLMA and in 86% using the IGSA (P = .147). The mean times required for placement were 27.1 seconds for the SLMA and 32.5 seconds for the IGSA (P = .195). The nasogastric tube was inserted on the first attempt in 97.6% of patients with an SLMA and in 85.7% of patients with an IGSA. The mean times required for tube insertion were 9.5 seconds through the SLMA and 22.1 seconds through the IGSA (P < .001). Seal pressure and compliance were similar in the 2 groups at the start of surgery and at 10, 30, and 60 minutes. The incidences of complications during surgery and at 90 minutes were likewise similar (P = .945 and P = .698, respectively).
The SLMA and the IGSA are easy to put into position on the first attempt. It is easier to insert the nasogastric tube through the gastric channel of the SLMA. Both devices provide an effective seal and the incidences of complications were similar for both in the patients we studied.
最高喉罩气道（SLMA）和I-gel声门上气道（IGSA）是最近推出的带有胃管通道的装置。本研究评估了这些装置的插入难易程度及其在机械通气中的效果。
85例接受全身麻醉下大型门诊手术的患者被随机分为两组，分别使用SLMA或IGSA进行插管。全身麻醉诱导后，插入指定的面罩，并用纤维喉镜检查其位置。评估插入的难易程度。测量密封压力，并在手术开始后10、30和60分钟记录以下通气参数：峰值压力、平均压力、顺应性以及潮气量与呼吸频率之比。还记录插入鼻胃管时的情况。
使用SLMA的患者中95.2%在首次尝试时即可放置气道，使用IGSA的患者中这一比例为86%（P = 0.147）。放置所需的平均时间，SLMA为27.1秒，IGSA为32.5秒（P = 0.195）。使用SLMA的患者中97.6%在首次尝试时即可插入鼻胃管，使用IGSA的患者中这一比例为85.7%。通过SLMA插入管子所需的平均时间为9.5秒，通过IGSA为22.1秒（P < 0.001）。手术开始时以及10、30和60分钟时，两组的密封压力和顺应性相似。手术期间及90分钟时并发症的发生率同样相似（分别为P = 0.945和P = 0.698）。
SLMA和IGSA在首次尝试时易于放置到位。通过SLMA的胃管通道插入鼻胃管更容易。两种装置都能提供有效的密封，在我们研究的患者中，两者并发症的发生率相似。
