Sastre J A, López T, Garzón J C
Servicio de Anestesiología y Reanimación, Complejo Asistencial Universitario de Salamanca, Salamanca, España.
Rev Esp Anestesiol Reanim. 2012 Feb;59(2):71-6. doi: 10.1016/j.redar.2012.02.016.
The use of supraglottic devices as a means of rescue in patients difficult to intubate or ventilate has increased in the field of anaesthetics and in emergency medicine. This study is designed to evaluate the success rate of blind intubations using two supraglottic devices, the Fastrach ILMA and the i-gel mask.
A total of 80 patients (40 per group) were included. After positioning them a leak test was performed, the glottis view was checked with a fibrobronchoscope, and an attempt was made to introduce an endotracheal tube through the device, and the procedure was repeated. Adequate ventilation was evaluated, as well as the grade of fibrobronchoscope view, the success of the intubation, and the complications observed after their use.
There were no differences in the incidence of adequate ventilation with either device. The glottis view (Brimacombe scale) was better with i-gel (77.78% versus 68.42%) at the second attempt, but not on the first. A higher percentage of intubations were achieved with the Fastrach ILMA (70% versus 40%; P=.013). The incidence of throat pain was similar with both devices, but post-operative dysphonia was more frequent with i-gel (20% versus 0; P=.0053).
Both devices were equally effective in achieving adequate ventilation; however, the Fastrach ILMA enabled a higher number of intubations to be made than i-gel and with a lower incidence of post-operative dysphonia.
在麻醉学和急诊医学领域,使用声门上装置作为困难插管或通气患者的一种救援手段的情况有所增加。本研究旨在评估使用两种声门上装置,即Fastrach ILMA和i-gel面罩进行盲插的成功率。
共纳入80例患者(每组40例)。对其进行体位摆放后进行漏气试验,用纤维支气管镜检查声门视野,并尝试通过该装置插入气管导管,然后重复该操作。评估通气是否充分、纤维支气管镜视野分级、插管成功率以及使用后观察到的并发症。
两种装置在通气充分发生率方面无差异。第二次尝试时,i-gel的声门视野(Brimacombe评分)更好(77.78%对68.42%),但第一次尝试时并非如此。Fastrach ILMA的插管成功率更高(70%对40%;P = 0.013)。两种装置的咽痛发生率相似,但i-gel术后声音嘶哑更常见(20%对0;P = 0.0053)。
两种装置在实现充分通气方面同样有效;然而,Fastrach ILMA比i-gel能完成更多的插管,且术后声音嘶哑的发生率更低。