Aydogmus Meltem Turkay, Eksioglu Birsen, Oba Sibel, Unsal Oya, Türk Hacer Sebnem Yeltepe, Sinikoglu Sitki Nadir, Tug Aslihan
Department of Anesthesiology and Reanimation, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Department of Anesthesiology and Reanimation, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Braz J Anesthesiol. 2013 Nov-Dec;63(6):445-9. doi: 10.1016/j.bjane.2012.08.004. Epub 2013 Dec 5.
Laryngeal mask airway (LMA), which has been used frequently in airway management, can cause laryngopharyngeal injury and morbidity. In this trial, we compare the macroscopic changes on laryngopharyngeal structures and the postoperative laryngopharyngeal morbidity by using LMA supreme with LMA proseal in children.
We divided patients into two groups. We inserted size three LMA proseal into the first group and size three LMA supreme into the second group. Before LMA insertion and after LMA removal, we performed direct laryngoscopy on the patients. We compared hyperemia, mucosal injury and blood staining on LMA removal, as well as insertion time, rate of success in gastric tube insertion on the first attempt, nausea, vomiting, and sore throat between the two groups.
We recorded no significant differences between the two groups for mean operation time, sex, age, weight, rate of success in gastric tube insertion on first attempt, nausea, vomiting, sore throat and mucosal injury. Mean insertion time for the LMA proseal group was significantly longer than the LMA supreme group (p = 0.0001). The ratio of blood staining on LMA removal was significantly higher in the LMA proseal group than the LMA supreme group (p = 0.034). The patients with blood staining on LMA removal exhibited significantly more mucosal hyperemia and injury than the patients with clear LMA (p = 0.0001, p = 0.020).
LMA supreme insertion is faster and easier than LMA proseal and causes less laryngopharyngeal injury than LMA proseal in children.
喉罩气道(LMA)在气道管理中应用频繁,但可导致喉咽损伤及并发症。在本试验中,我们比较了儿童使用LMA supreme和LMA proseal时喉咽结构的宏观变化及术后喉咽并发症。
我们将患者分为两组。第一组插入3号LMA proseal,第二组插入3号LMA supreme。在插入LMA前及拔除LMA后,对患者进行直接喉镜检查。我们比较了拔除LMA时的充血、黏膜损伤和血染情况,以及两组之间的插入时间、首次插入胃管的成功率、恶心、呕吐和咽痛情况。
两组在平均手术时间、性别、年龄、体重、首次插入胃管的成功率、恶心、呕吐、咽痛和黏膜损伤方面无显著差异。LMA proseal组的平均插入时间显著长于LMA supreme组(p = 0.0001)。LMA proseal组拔除LMA时的血染率显著高于LMA supreme组(p = 0.034)。拔除LMA时有血染的患者比LMA清洁的患者表现出明显更多的黏膜充血和损伤(p = 0.0001,p = 0.020)。
在儿童中,插入LMA supreme比LMA proseal更快、更容易,且导致的喉咽损伤比LMA proseal更少。