Goldmann Kai
Department of Anaesthesia, Dubai Hospital, Dubai, United Arab Emirates.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2013 Apr;48(4):246-50. doi: 10.1055/s-0033-1343759. Epub 2013 Apr 30.
The development of the LMA-Classic™ revolutionized anaesthesia practice as its wide-spread use led to the establishment of a unique form of airway management, the "supraglottic airway management", besides the existing classical airway management with the face mask or endotracheal tube. Today, 25 years later, along with the original prototype of supraglottic airways quite a few numbers of different devices exist that can be used to secure the airway "above the glottis". After initially primarily marketing adult sizes many suppliers offer paediatric sizes nowadays. However, the scientific evidence in terms of superiority or at a least equality to the original LMA-Classic( of any of these airway devices must be considered insufficient except for the LMA-ProSeal™. Consequently, the routine use of these devices outside controlled clinical studies must be considered questionable. The following article aims at providing a critical appraisal of currently available supraglottic airway devices for neonates and infants.
喉罩经典版(LMA-Classic™)的问世彻底改变了麻醉实践,因为其广泛应用催生了一种独特的气道管理形式,即“声门上气道管理”,这是除了现有的使用面罩或气管内导管的传统气道管理之外的又一种方式。25年后的今天,除了声门上气道的原始原型外,还有相当数量的不同装置可用于确保“声门上方”的气道安全。最初主要销售成人尺寸产品后,如今许多供应商也提供儿科尺寸产品。然而,除了喉罩ProSeal™(LMA-ProSeal™)之外,这些气道装置中任何一种在优越性或至少与原始喉罩经典版(LMA-Classic™)等效性方面的科学证据都被认为是不足的。因此,在对照临床研究之外常规使用这些装置的做法值得怀疑。以下文章旨在对目前可用于新生儿和婴儿的声门上气道装置进行批判性评估。