Department of Anaesthesia, Changi General Hospital, Singapore.
Anaesthesia. 2012 Sep;67(9):986-90. doi: 10.1111/j.1365-2044.2012.07167.x. Epub 2012 Jun 11.
The Laryngeal Mask Airway Flexible™ (LMA Flexible) has been widely utilised for dental, ophthalmology and otorhinolaryngology-related procedures. Our study evaluates two different techniques of inserting the LMA Flexible for patients undergoing day-case dental surgery. One hundred and eight patients were randomly assigned into two groups based on the LMA Flexible insertion technique--either laryngoscopy-guided (n=54) or digital manipulation (standard technique; n=54). Patient and airway characteristics were recorded before induction of anaesthesia. The primary outcome was success rate at first insertion. Other outcomes assessed included fibreoptic assessment of laryngeal mask airway placement, haemodynamic changes, need for airway adjustment during surgery and sore throat. The success rate of insertion on the first attempt was higher for the laryngoscopy-assisted technique compared with the standard technique (96.3% vs 81.5%, respectively, p<0.05). Fibreoptic assessment showed that the former group had better placement of the laryngeal mask airway than the latter (59.3% vs 37% p<0.05). There were no significant differences between the two groups for haemodynamic changes. Sore throat was more common in the group with the standard technique (35.2% vs 16.7%, p<0.05). Our study suggests the use of the laryngoscope to guide insertion of the LMA Flexible for dental surgery is a better option compared with the standard technique of digital manipulation.
喉罩气道柔性™（LMA 柔性）已广泛应用于牙科、眼科和耳鼻喉科相关手术。我们的研究评估了两种不同的 LMA 柔性插入技术，用于接受日间牙科手术的患者。108 名患者根据 LMA 柔性插入技术随机分为两组 - 喉镜引导（n=54）或数字操作（标准技术；n=54）。在麻醉诱导前记录患者和气道特征。主要结局是首次插入的成功率。评估的其他结果包括纤维光学评估喉罩气道位置、血流动力学变化、手术期间气道调整的需要以及咽喉痛。与标准技术相比，喉镜辅助技术的插入成功率更高（分别为 96.3%和 81.5%，p<0.05）。纤维光学评估显示，前一组的喉罩气道位置优于后一组（分别为 59.3%和 37%，p<0.05）。两组之间血流动力学变化无显著差异。标准技术组的咽喉痛更为常见（分别为 35.2%和 16.7%，p<0.05）。我们的研究表明，与标准的数字操作技术相比，使用喉镜引导插入 LMA 柔性是牙科手术的更好选择。
