Barreira Sara R, Souza Camila Machado, Fabrizia Fernanda, Azevedo Ana Bárbara G, Lelis Talitha G, Lutke Claudia
Department of Anesthesiology, Pain, and Intensive Care, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Department of Anesthesiology, Pain, and Intensive Care, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Braz J Anesthesiol. 2013 Nov-Dec;63(6):456-60. doi: 10.1016/j.bjane.2012.08.003. Epub 2013 Dec 5.
Supraglottic airway devices are increasingly used as an option to tracheal intubation for elective procedures of varying complexity. The aim of this study was to prospectively evaluate the clinical use of the laryngeal mask airway Supreme(®) (LMAS) in patients undergoing elective breast surgery and compare it with endotracheal tube (ETT).
Sixty patients undergoing breast procedures under general anesthesia were randomly divided into two groups according to the device used (LMAS or ETT). Time of insertion, number of insertion attempts, hemodynamic response to insertion, presence of blood on the device used; and incidence of sore throat, dysphagia, nausea and vomiting were assessed postoperatively.
There was no difference between groups regarding time of insertion, number of attempts for successful insertion, and presence of blood on the device. Heart rate and blood pressure after insertion were higher in ETT group. Incidence of sore throat and dysphagia was also higher in ETT group after two hours in the postoperative period. There was no difference regarding incidence and severity of complications evaluated after six hours postoperatively.
The use of the LMAS technique to access airway during general anesthesia for elective breast surgery is as safe and effective as tracheal intubation, with the advantage of promoting smaller hemodynamic response during its management and lower incidence of sore throat and dysphagia in the first hours after surgery.
对于各种复杂程度的择期手术，声门上气道装置越来越多地被用作气管插管的替代选择。本研究的目的是前瞻性评估喉罩气道至尊型（LMAS）在择期乳房手术患者中的临床应用，并将其与气管内插管（ETT）进行比较。
60例接受全身麻醉下乳房手术的患者根据使用的装置（LMAS或ETT）随机分为两组。评估插入时间、插入尝试次数、插入时的血流动力学反应、所用装置上是否有血迹；以及术后咽痛、吞咽困难、恶心和呕吐的发生率。
两组在插入时间、成功插入的尝试次数和装置上是否有血迹方面无差异。ETT组插入后的心率和血压较高。术后两小时ETT组咽痛和吞咽困难的发生率也较高。术后六小时评估的并发症发生率和严重程度无差异。
在择期乳房手术的全身麻醉期间，使用LMAS技术建立气道与气管插管一样安全有效，其优点是在操作过程中引起的血流动力学反应较小，且术后最初几小时咽痛和吞咽困难的发生率较低。
