Woo Young Cheol, Cha Su Man, Kang Hyun, Baek Chong Wha, Jung Yong Hun, Kim Jin Yun, Koo Gill Hoi, Park Sun Gyoo, Kim Seong Deok
Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, 224-1 Heukseok-dong, Dongjak-gu, Seoul, 156-755, Korea.
Can J Anaesth. 2011 Jan;58(1):48-54. doi: 10.1007/s12630-010-9412-3. Epub 2010 Nov 2.
The aim of this study was to compare the Streamlined Liner of the Pharynx Airway (SLIPA™) with the ProSeal Laryngeal Mask Airway (LMA-ProSeal™) in mechanically ventilated paralyzed patients undergoing laparoscopic gynecologic surgery.
One hundred and one patients were allocated randomly to SLIPA (n = 50) or to LMA-ProSeal (n = 51) treatment groups. After induction of general anesthesia and insertion of the assigned supralaryngeal airway (SLA) device, we made note of the occurrence of any gastric insufflation and perilaryngeal leakage. We then evaluated the anatomical fit of the SLA device using a fibreoptic bronchoscope, and we assessed the airway sealing pressure and respiratory mechanics with change in head position and during peritoneal insufflation. After surgery, we evaluated the severity of postoperative sore throat and the presence of blood or regurgitated fluid on the SLA device.
The insertion success rate, gastric insufflation, perilaryngeal leakage, anatomical fit, airway sealing pressure, respiratory mechanics, severity of sore throat, and incidence of blood and regurgitated fluid on the device were similar between the two groups. The incidence of perilaryngeal leakage with changes in the patient's head position was lower with the SLIPA group than with the LMA-ProSeal group (3/50 vs 11/51, respectively; P = 0.026). During peritoneal insufflation, perilaryngeal leakage did not occur with the SLIPA but occurred in four cases with the LMA-ProSeal (P = 0.045).
Both the SLIPA and the LMA-ProSeal can be used effectively and without severe complications in paralyzed patients undergoing laparoscopic gynecological surgery. However, the SLIPA offers the advantage of less perilaryngeal gas leakage than the LMA-ProSeal with change in head position and during insufflation of the peritoneal cavity. This trial is registered with ANZCTR (ACTRN12609000914268).
本研究旨在比较在接受腹腔镜妇科手术的机械通气麻痹患者中，咽气道简化型喉罩（SLIPA™）与双管喉罩（LMA-ProSeal™）的效果。
101例患者被随机分配至SLIPA组（n = 50）或LMA-ProSeal组（n = 51）。在全身麻醉诱导并插入指定的喉上气道（SLA）装置后，我们记录任何胃充气和喉周漏气的发生情况。然后，我们使用纤维支气管镜评估SLA装置的解剖学贴合度，并在头部位置改变和腹腔充气期间评估气道密封压力和呼吸力学。术后，我们评估术后咽痛的严重程度以及SLA装置上是否有血液或反流液体。
两组在插入成功率、胃充气、喉周漏气、解剖学贴合度、气道密封压力、呼吸力学、咽痛严重程度以及装置上血液和反流液体的发生率方面相似。SLIPA组因患者头部位置改变导致的喉周漏气发生率低于LMA-ProSeal组（分别为3/50和11/51；P = 0.026）。在腹腔充气期间，SLIPA组未发生喉周漏气，而LMA-ProSeal组有4例发生（P = 0.045）。
SLIPA和LMA-ProSeal均可有效地用于接受腹腔镜妇科手术的麻痹患者，且无严重并发症。然而，与LMA-ProSeal相比，SLIPA在头部位置改变和腹腔充气期间具有喉周气体泄漏较少的优势。本试验已在澳大利亚和新西兰临床试验注册中心注册（ACTRN12609000914268）。
