Amini Afshin, Zand Farid, Maghbooli Masoud
Shiraz University of Medical Sciences Anesthesiology and Critical Care Medicine Research Center, Shiraz, Iran.
Rev Bras Anestesiol. 2010 Jan-Feb;60(1):32-41. doi: 10.1016/s0034-7094(10)70004-0.
The laryngeal tube suction II (LTS-II) is a recent version of reusable supraglottic airway devices allowing gastric drainage. In this prospective, randomized study we compared insertion and ventilation of disposable LTS-II (LTS-D) with reusable type (LTS-II) for airway management under conditions with elevated intra abdominal pressure induced by capnoperitoneum.
60 ASA I and II patients undergoing elective laparoscopic cholecystectomy were randomized to receive either a LTS-D (n=30) or LTS-II (n=30) for airway management. After induction of general anaesthesia the devices were inserted, their correct placement was verified and airway leak pressure was measured. Ease of insertion, quality of airway seal, fiberoptic view, risk of gastric insufflation, insertion of nasogastric tube and postoperative pharyngeal morbidity were examined.
First time and second time success rates were comparable for both groups (86% vs. 93% and 96% vs. 96% in LTS-D and LTS-II groups, respectively). One patient in each group could not be intubated after three attempts. After gas insufflation, ventilation of one patient in LTS-D and 2 patients in LTS-II groups was faulty and the patients were intubated with endotracheal tube. Time until delivery of first tidal volume for LTS-D and LTS-II was 20.8 +/- 11.6 s, and 18.2 +/- 4.8 seconds respectively (p = 0.27), fixation and manipulation time was 73.3 +/- 18.5 and 65.5 +/- 16.2 seconds, respectively (p = 0.096). Nasogastric tube insertion was successful in all patients. There were no significant differences in postoperative complaints.
Both devices provide a secure airway under conditions of elevated intra abdominal pressure.
喉罩抽吸二代（LTS-II）是一种新型可重复使用的声门上气道装置，可实现胃引流。在这项前瞻性随机研究中，我们比较了一次性喉罩抽吸二代（LTS-D）和可重复使用型（LTS-II）在二氧化碳气腹导致腹内压升高情况下用于气道管理时的插入和通气情况。
60例接受择期腹腔镜胆囊切除术的美国麻醉医师协会（ASA）I级和II级患者被随机分为两组，分别使用LTS-D（n = 30）或LTS-II（n = 30）进行气道管理。全身麻醉诱导后插入装置，确认其正确位置并测量气道漏气压力。检查插入的难易程度、气道密封质量、纤维喉镜视野、胃充气风险、鼻胃管插入情况及术后咽部并发症。
两组的首次和二次成功率相当（LTS-D组分别为86%和96%，LTS-II组分别为93%和96%）。每组各有1例患者在三次尝试后仍无法插管。充气后，LTS-D组有1例患者和LTS-II组有2例患者通气出现故障，随后均行气管内插管。LTS-D和LTS-II输送首个潮气量的时间分别为20.8±11.6秒和18.2±4.8秒（p = 0.27），固定和操作时间分别为73.3±18.5秒和65.5±16.2秒（p = 0.096）。所有患者鼻胃管插入均成功。术后主诉无显著差异。
在腹内压升高的情况下，两种装置均能提供安全的气道。
