From the Medical Faculty of Kocaeli University, Department of Anesthesiology and Reanimation, Umuttepe/Kocaeli, Turkey.
Eur J Anaesthesiol. 2014 May;31(5):280-4. doi: 10.1097/EJA.0000000000000062.
Supraglottic airway devices such as the LMA-Supreme (LMA-S) and I-gel, which have an additional lumen for the insertion of a gastric tube, can be useful in the management of the difficult airway.
To test the performance of these two devices in the difficult paediatric airway.
Randomised double-blind study.
Anaesthesia department, university hospital.
Sixty American Society of Anesthesiologists (ASA) I-II children undergoing elective surgery.
After obtaining ethical approval and written informed consent from the parents, we compared the size 2 LMA-S with the I-gel in a simulated airway scenario made more difficult by using a cervical collar to limit mouth opening and neck movement.
The primary aim was to compare the oropharyngeal leak pressure of the LMA-S and the I-gel. The secondary aims were to compare success rate, insertion time, time to pass a gastric tube and fibreoptic view of the larynx.
Oropharyngeal leak pressure (mean ± SD) for the LMA-S was significantly higher than with the I-gel (20.9 ± 3.2 versus 18.9 ± 3.2 cmH2O, P = 0.019). First attempt success rate for the LMA-S was 100 and 90% for the I-gel (P > 0.05). Insertion time of the LMA-S was shorter than I-gel (11.2 ± 1.8 versus 13.5 ± 2.4 s, P = 0.001). Gastric tube placement was possible in all patients. The mean insertion time of the gastric tube was shorter with the LMA-S than with the I-gel (10.3 ± 3.6 versus 12.7 ± 3.2 s, P = 0.009). Fibreoptic laryngeal views were similar in both groups.
In the simulated difficult airway in children, both airway devices provided effective ventilation. Paediatric size 2 LMA-S sustained a higher airway pressure before leaking and was quicker to insert than the I-gel equivalent. These differences may not be clinically significant.
具有用于插入胃管的附加管腔的声门上气道装置（例如 LMA-Supreme [LMA-S] 和 I-gel）在困难气道的管理中可能很有用。
测试这两种设备在困难儿科气道中的性能。
随机双盲研究。
大学医院麻醉科。
六十名接受择期手术的美国麻醉师协会（ASA）I-II 级儿童。
在获得伦理批准和父母书面知情同意后，我们在模拟气道场景中比较了大小为 2 的 LMA-S 和 I-gel，该场景通过使用颈圈限制开口和颈部运动使气道更加困难。
主要目的是比较 LMA-S 和 I-gel 的口咽漏气压。次要目的是比较成功率、插入时间、通过胃管的时间和喉镜下的喉部视图。
LMA-S 的口咽漏气压（平均值±标准差）显着高于 I-gel（20.9±3.2 对 18.9±3.2 cmH2O，P=0.019）。LMA-S 的首次尝试成功率为 100%，而 I-gel 的成功率为 90%（P>0.05）。LMA-S 的插入时间短于 I-gel（11.2±1.8 对 13.5±2.4 s，P=0.001）。所有患者均可行胃管放置。LMA-S 的胃管插入时间平均短于 I-gel（10.3±3.6 对 12.7±3.2 s，P=0.009）。两组的纤维光学喉部视图相似。
在儿童模拟困难气道中，两种气道装置均能提供有效通气。儿科大小 2 的 LMA-S 在漏气前维持更高的气道压力，并且比 I-gel 等效物插入更快。这些差异可能没有临床意义。
