Department of Anesthesia, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada,
Can J Anaesth. 2013 Dec;60(12):1197-203. doi: 10.1007/s12630-013-0044-2. Epub 2013 Oct 5.
Excessive supraglottic airway cuff pressure increases postoperative pharyngolaryngeal symptoms such as sore throat, dysphonia, and dysphagia. A new supraglottic airway, AES Ultra CPV™ (CPV), has a built-in intracuff pressure indicator. We hypothesized that using the CPV would reduce postoperative symptoms when compared with the LMA Classic™ (LMA) without intracuff pressure guidance.
Ambulatory patients undergoing general anesthesia were randomized to either CPV or LMA. A size 3/4/5 was inserted according to manufacturer guidelines. Nitrous oxide was not used. In the LMA Group, the cuff was inflated according to manufacturer's guidelines. In the CPV Group, a CPV was inserted and the cuff inflated until the indicator was in the green zone (30-44 mmHg). Intracuff pressures were measured at five minutes and 20 min post-insertion in both groups. The primary outcome was the incidence of pharyngolaryngeal symptoms, defined as sore throat, dysphonia, and/or dysphagia at one, two, and/or 24 hr postoperatively. Continuous data were compared using Student's t test and categorical data were analyzed using Chi square analysis.
The study included 170 patients, 85 per group. The mean (SD) intracuff pressure in the CPV group was significantly lower [44 (4) mmHg] than in the LMA Group [87 (37) mmHg]; P < 0.001. The incidence of pharyngolaryngeal symptoms was significantly lower in the CPV Group than in the LMA Group (26% vs 49%; P = 0.002). The absolute risk reduction was 24%, and the number-needed-to-treat was 4.3.
The incidence of postoperative pharyngolaryngeal symptoms in the CPV Group with a cuff pressure-guided strategy was significantly lower than in the LMA Group with standard practice. (
NCT01800344).
过度的声门上气道套囊压力会增加术后咽喉部症状，如咽痛、声音嘶哑和吞咽困难。一种新型的声门上气道装置 AES Ultra CPV™（CPV）内置有套囊内压力指示器。我们假设与没有套囊内压力指导的 LMA Classic™（LMA）相比，使用 CPV 会降低术后症状。
择期全身麻醉的患者被随机分为 CPV 组或 LMA 组。根据制造商的指南插入 3/4/5 号器械。不使用一氧化二氮。在 LMA 组，根据制造商的指南充气套囊。在 CPV 组，插入 CPV 并充气直至指示器处于绿色区域（30-44mmHg）。在两组中，在插入后 5 分钟和 20 分钟测量套囊内压力。主要结局是咽喉部症状的发生率，定义为术后 1、2 和/或 24 小时时出现咽痛、声音嘶哑和/或吞咽困难。连续数据采用 Student's t 检验进行比较，分类数据采用卡方分析进行分析。
该研究纳入了 170 例患者，每组 85 例。CPV 组的平均（SD）套囊内压力明显低于 LMA 组[44（4）mmHg] [87（37）mmHg]；P < 0.001。CPV 组的咽喉部症状发生率明显低于 LMA 组（26%比 49%；P = 0.002）。绝对风险降低 24%，需要治疗的人数为 4.3。
CPV 组采用套囊压力指导策略的术后咽喉部症状发生率明显低于 LMA 组采用标准操作。（临床试验注册号：NCT01800344）。
