小儿型 i-gel 与 Ambu AuraOnce 喉罩在麻醉通气患儿中的应用比较。

Performance of the pediatric-sized i-gel compared with the Ambu AuraOnce laryngeal mask in anesthetized and ventilated children.

机构信息

Department of Anesthesiology and Pain Therapy, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.

出版信息

Anesthesiology. 2011 Jul;115(1):102-10. doi: 10.1097/ALN.0b013e318219d619.

DOI:10.1097/ALN.0b013e318219d619

PMID:21572318

Abstract

BACKGROUND

This prospective, randomized, controlled trial compares the performance of the pediatric i-gel (Intersurgical Ltd., Wokingham, United Kingdom) with the Ambu AuraOnce laryngeal mask (Ambu A/S, Ballerup, Denmark) in anesthetized and ventilated children.

METHODS

With ethics committee approval and written informed consent, the authors included 208 children, aged 0-17 yr, scheduled for elective day-surgery under general anesthesia. The primary outcome variable was oropharyngeal leak pressure. Other outcome variables were first-attempt and overall success, time to sufficient ventilation, and adverse events.

RESULTS

Demographic data did not differ between groups. The leak pressure of the i-gel was significantly higher than the leak pressure of the Ambu (mean ± SD: 22 ± 5 cm H₂O vs. 19 ± 3, P < 0.01). First-attempt success was 91% for the i-gel and 93% for the Ambu (P = 0.50). Overall success was 93% for the i-gel versus 98% for the Ambu (P = 0.10). Successfully inserted i-gels needed to be secured by taping in place to ensure the seal in 44% (0% with the Ambu, P < 0.01). Insertion was faster with the Ambu (24 ± 8 s vs. 27 ± 11, P = 0.02). There were no major side effects with either device.

CONCLUSIONS

The leak pressure of the i-gel was statistically but not clinically significantly higher than the leak pressure of the Ambu. Time to insertion was longer with the i-gel. Both airway devices are suitable for positive pressure ventilation with high success rates in infants and children. Because the i-gel is prone to sliding out, it must be taped in place to avoid loss of the airway.

摘要

背景

本前瞻性、随机、对照试验比较了小儿 i-gel（英国沃金汉的 Intersurgical Ltd.）和 Ambu AuraOnce 喉罩（丹麦 Ballerup 的 Ambu A/S）在麻醉和通气儿童中的性能。

方法

在伦理委员会批准和书面知情同意的情况下，作者纳入了 208 名年龄 0-17 岁、拟在全身麻醉下择期行日间手术的儿童。主要结局变量为口咽漏压。其他结局变量为首次尝试和总成功率、达到充分通气的时间和不良事件。

结果

两组患儿的人口统计学数据无差异。i-gel 的漏压显著高于 Ambu（均数±标准差：22±5cmH₂O 比 19±3cmH₂O，P<0.01）。i-gel 的首次尝试成功率为 91%，Ambu 为 93%（P=0.50）。i-gel 的总成功率为 93%，Ambu 为 98%（P=0.10）。为确保密封，需用胶带固定 i-gel 以确保密封，成功率为 44%（Ambu 为 0%，P<0.01）。Ambu 的插入速度更快（24±8s 比 27±11s，P=0.02）。两种装置均无严重不良反应。