Lalwani Jaya, Dubey Kamta Prasad, Sahu Bal Swaroop, Shah Pratibha Jain
Pt. J.N.M. Medical College & Dr. BRAM Hospital, Raipur (C.G.), India.
Indian J Anaesth. 2010 Nov;54(6):541-5. doi: 10.4103/0019-5049.72644.
The laryngeal mask airway (LMA) is a supraglottic airway management device. The LMA is preferred for airway management in paediatric patients for short duration surgical procedures. The recently introduced ProSeal (PLMA), a modification of Classic LMA, has a gastric drainage tube placed lateral to main airway tube which allows the regurgitated gastric contents to bypass the glottis and prevents the pulmonary aspiration. This study was done to compare the efficacy of ProSeal LMA with an endotracheal tube in paediatric patients with respect to number of attempts for placement of devices, haemodynamic responses and perioperative respiratory complications. Sixty children, ASA I and II, weighing 10-20 kg between 2 and 8 years of age group of either sex undergoing elective ophthalmological and lower abdominal surgeries of 30-60 min duration, randomly divided into two groups of 30 patients each were studied. The number of attempts for endotracheal intubation was less than the placement of PLMA. Haemodynamic responses were significantly higher (P<0.05) after endotracheal intubation as compared to the placement of PLMA. There were no significant differences in mean SpO(2) (%) and EtCO(2) levels recorded at different time intervals between the two groups. The incidence of post-operative respiratory complications cough and bronchospasm was higher after extubation than after removal of PLMA. The incidence of soft tissue trauma was noted to be higher for PLMA after its removal. There were no incidences of aspiration and hoarseness/sore throat in either group. It is concluded that ProSeal LMA can be safely considered as a suitable and effective alternative to endotracheal intubation in paediatric patients for short duration surgical procedures.
喉罩气道（LMA）是一种声门上气道管理装置。在小儿患者进行短时间外科手术时，LMA是气道管理的首选。最近推出的ProSeal喉罩（PLMA）是经典LMA的一种改良型，在主气道管的外侧放置了一根胃引流管，可使反流的胃内容物绕过声门，防止肺误吸。本研究旨在比较ProSeal喉罩与气管内导管在小儿患者中放置装置的尝试次数、血流动力学反应及围手术期呼吸并发症方面的疗效。选取60例年龄在2至8岁、体重10至20 kg、ASA分级为I级和II级、性别不限、择期进行30至60分钟眼科和下腹部手术的患儿，随机分为两组，每组30例进行研究。气管内插管的尝试次数少于PLMA的放置次数。与放置PLMA相比，气管内插管后的血流动力学反应显著更高（P<0.05）。两组在不同时间间隔记录的平均SpO₂（%）和EtCO₂水平无显著差异。拔管后术后呼吸并发症咳嗽和支气管痉挛的发生率高于拔除PLMA后。PLMA拔除后软组织创伤的发生率更高。两组均未发生误吸和声音嘶哑/咽痛。结论是，在小儿患者进行短时间外科手术时，ProSeal喉罩可被安全地视为气管内插管的一种合适且有效的替代方法。
