Anesthesiology and Reanimation Department, Kocaeli University School of Medicine, Kocaeli, Turkey.
Acta Anaesthesiol Scand. 2013 Sep;57(8):996-1001. doi: 10.1111/aas.12149. Epub 2013 Jun 27.
Supreme laryngeal mask airway (S-LMA) has been improved in recent years, but comparative studies with a sizeable number of paediatric patients are limited in number. In this study, oropharyngeal leak pressures (OLPs) were compared between S-LMA and ProSeal laryngeal mask airway (P-LMA) in paediatric patients.
After obtaining approval from the ethics committee and written informed consent from the relatives of the patients, 60 patients, from 9 months to 5 years of age and 10-20 kg in weight, who were recommended for elective surgery were included in this prospective and randomised study. The patients were assigned to the S-LMA and P-LMA groups. OLP, insertion times, success rates, ease of airway device placement, fibre optical assessment, success rates and insertion times of an orogastric tube (OGT) were compared.
P-LMA was placed successfully in all the patients. One patient was intubated in the S-LMA group. The outcomes of a total of 59 patients were analysed. The insertion times of the airway devices were shorter in the S-LMA group than in the P-LMA group (S-LMA; 12.2 ± 2.9, P-LMA; 15.4 ± 3.7 s) (P = 0.001). The first insertion attempts of airway device placement were similar. The OLPs were similar (P-LMA; 17.2 ± 2.3, S-LMA; 16.4 ± 1.7 cm H2 O). The fibre-optically determined anatomic position was better in the P-LMA group (P = 0.02). The insertion time of the OGT was shorter with S-LMA than with P-LMA (P = 0.01).
Our findings suggest that S-LMA has OLPs similar to those of P-LMA in paediatric patients and that S-LMA provides successful positive pressure ventilation.
近年来,高级喉罩气道(S-LMA)得到了改进,但在大量儿科患者中进行的比较研究数量有限。本研究比较了 S-LMA 与 ProSeal 喉罩气道(P-LMA)在儿科患者中的经口咽漏压(OLP)。
本前瞻性随机研究获得伦理委员会批准,并获得患者家属的书面知情同意后,纳入 60 名 9 个月至 5 岁、体重 10-20kg 的患者,这些患者推荐行择期手术。患者被分为 S-LMA 组和 P-LMA 组。比较 OLP、插入时间、成功率、气道装置放置的难易程度、光纤评估、胃管(OGT)的成功率和插入时间。
所有患者均成功放置 P-LMA。S-LMA 组有 1 例患者需插管。共分析了 59 例患者的结果。S-LMA 组的气道装置插入时间短于 P-LMA 组(S-LMA:12.2±2.9s,P-LMA:15.4±3.7s)(P=0.001)。首次尝试放置气道装置时,两组结果相似。OLP 也相似(P-LMA:17.2±2.3cmH2O,S-LMA:16.4±1.7cmH2O)。P-LMA 组光纤确定的解剖位置更好(P=0.02)。S-LMA 组 OGT 插入时间短于 P-LMA 组(P=0.01)。
我们的发现表明,S-LMA 在儿科患者中的 OLP 与 P-LMA 相似,并且 S-LMA 可提供成功的正压通气。