Karippacheril John G, Varghese Elsa
Department of Anaesthesiology, Kasturba Medical College, Manipal University, Manipal, India.
Paediatr Anaesth. 2011 Jun;21(6):668-72. doi: 10.1111/j.1460-9592.2011.03554.x. Epub 2011 Mar 3.
To compare airway sealing pressures, air leak, optimal positioning of the LMA-ProSeal™ and LMA-Classic™ in children.
A crossover, randomized study was conducted in children aged 6 months-7 years weighing <20 kg scheduled for minor elective surgery under GA with sevoflurane. Either a 1.5 or 2-size LMA-ProSeal™ or LMA-Classic™ was inserted first. Optimal position of the devices was evaluated by fiberoptic bronchoscopy (FOB). Airway sealing pressures were determined under standardized conditions by the manometric stability test at the proximal end of the LMA device. Gas leak observed by auscultation over the neck and epigastrium was noted at these pressures.
Twenty-seven children of mean ages 29.48 ± 19.81 months and mean weight 11.23 ± 3.28 kg were included for evaluation. Airway sealing pressures were noted to be similar: 23.11 ± 8.28 cm H(2)O with LMA-ProSeal™ and 23.26 ± 8.21 cm H(2)O with LMA-Classic™. At these sealing pressures, air leak in the neck was observed in 21/27 children with LMA-ProSeal™ compared with 24/27 with LMA-Classic™ (P = 0.467). Optimal device positioning as viewed by FOB was seen in 14/27(51.8%) children with LMA-ProSeal™ and 15/27(55.6%) with LMA-Classic™. Airway sealing pressures with suboptimal position of LMA-ProSeal™ was 22.23 ± 10.23 cm H(2)O and with optimal position 23.93 ± 6.25 cm H(2)O (P = 0.612).
The LMA-ProSeal™ and LMA-Classic™ size 1.5 and 2 provide similar mean airway sealing pressures as assessed by the manometric stability test under standardized conditions, with similar air leak and optimal positioning.
比较儿童使用LMA-ProSeal™和LMA-Classic™时的气道密封压力、漏气情况及最佳位置。
对年龄在6个月至7岁、体重<20 kg、计划在全身麻醉下使用七氟醚进行小型择期手术的儿童进行一项交叉随机研究。首先插入1.5号或2号的LMA-ProSeal™或LMA-Classic™。通过纤维支气管镜（FOB）评估设备的最佳位置。在标准化条件下，通过LMA设备近端的压力稳定性测试确定气道密封压力。在这些压力下，记录通过颈部和上腹部听诊观察到的漏气情况。
纳入27名平均年龄29.48±19.81个月、平均体重11.23±3.28 kg的儿童进行评估。气道密封压力相似：LMA-ProSeal™为23.11±8.28 cm H₂O，LMA-Classic™为23.26±8.21 cm H₂O。在这些密封压力下，21/27使用LMA-ProSeal™的儿童颈部出现漏气，而使用LMA-Classic™的为24/27（P = 0.467）。通过FOB观察，14/27（51.8%）使用LMA-ProSeal™的儿童和15/27（55.6%）使用LMA-Classic™的儿童设备位置最佳。LMA-ProSeal™位置欠佳时的气道密封压力为22.23±10.23 cm H₂O，位置最佳时为23.93±6.25 cm H₂O（P = 0.612）。
在标准化条件下通过压力稳定性测试评估，1.5号和2号的LMA-ProSeal™和LMA-Classic™提供相似的平均气道密封压力，漏气情况和最佳位置也相似。
