Hurtado P, Valero R, Tercero J, Carrero E, de Riva N, López A M, Enseñat J, Ubré M, Lushchenkov D, Fàbregas N
Servicio de Anestesiologia, Reanimación y Terapéutica del Dolor, Hospital Clinicá de Barcelona.
Rev Esp Anestesiol Reanim. 2011 Jun-Jul;58(6):362-4. doi: 10.1016/s0034-9356(11)70085-8.
To describe the use, utility, safety, and effectiveness of the Proseal laryngeal mask for airway management in patients undergoing ventriculoperitonea shunting.
We retrospectively reviewed the records of all patients in whom the Proseal laryngeal mask was used during ventriculoperitoneal shunting between January 2006 and October 2009. Patient demographic characteristics, airway assessments, type of anesthesia, quality of ventilation, and perioperative complications were recorded.
Of the 43 patients included, 8 (18.6%) had at least 1 difficult airway criterion. We were able to insert the Proseal laryngeal mask in all patients. Ventilation was optimal in 39 (91%) patients, with maintenance of end-expiratory carbon dioxide pressures between 35 and 40 mm Hg and airway pressures above 25 cm H2O throughout the procedures. Air leaks developed in 3 cases (7%) when the patient was placed in a lateral-cervical position for surgery; these patients required orotracheal intubation before surgery could begin. Mean duration of surgery was 53 minutes. Awakening occurred without incident in all cases.
The Proseal laryngeal mask is useful for airway management in patients undergoing ventriculoperitoneal shunting. Due to the forced position of the neck, however, it may be necessary to reposition the mask or even proceed to orotracheal intubation in some cases. As is the case for other advanced uses, experience with the device is necessary. Material for managing a difficult airway should be on hand.
描述食管引流型喉罩在脑室腹腔分流术患者气道管理中的应用、效用、安全性及有效性。
我们回顾性分析了2006年1月至2009年10月期间在脑室腹腔分流术时使用食管引流型喉罩的所有患者的记录。记录患者的人口统计学特征、气道评估、麻醉类型、通气质量及围手术期并发症。
纳入的43例患者中，8例（18.6%）至少有1项困难气道标准。我们成功为所有患者置入了食管引流型喉罩。39例（91%）患者通气良好，整个手术过程中呼气末二氧化碳压力维持在35至40 mmHg之间，气道压力高于25 cm H₂O。3例（7%）患者在手术时处于颈侧位时出现漏气；这些患者在手术开始前需要行气管插管。平均手术时间为53分钟。所有病例均顺利苏醒。
食管引流型喉罩在脑室腹腔分流术患者的气道管理中有用。然而，由于颈部的强迫体位，在某些情况下可能需要重新调整喉罩位置，甚至进行气管插管。与其他高级应用一样，使用该设备需要经验。应准备好处理困难气道的材料。
