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在未行肌松的全身麻醉下接受择期手术的成年患者中,I-gel喉罩与Proseal喉罩的比较:一项前瞻性随机研究。

Comparison of I-gel with proseal LMA in adult patients undergoing elective surgical procedures under general anesthesia without paralysis: A prospective randomized study.

作者信息

Kini Gurudas, Devanna Gopalkrishna Mettinadka, Mukkapati Koteswara Rao, Chaudhuri Souvik, Thomas Daniel

机构信息

Departments of Anaesthesia, Kasturba Medical College, Manipal, Karnataka, Department of Anaesthesia and Critical Care, Kasturba Medical College, Manipal University, Karnataka, India.

出版信息

J Anaesthesiol Clin Pharmacol. 2014 Apr;30(2):183-7. doi: 10.4103/0970-9185.130008.

Abstract

BACKGROUND

We compared i-gel and ProSeal laryngeal mask airway (PLMA) regarding time taken for insertion, effective seal, fiberoptic view of larynx, ease of Ryle's tube insertion, and postoperative sore throat assessment.

MATERIALS AND METHODS

In a prospective, randomized manner, 48 adult patients of American Society of Anesthesiologists I-II of either gender between 18 and 60 years presenting for a short surgical procedure were assigned to undergo surgery under general anesthesia on spontaneous ventilation using either the i-gel or PLMA. An experienced nonblinded anesthesiologist inserted appropriate sized i-gel or PLMA in patients using standard insertion technique and assessed the intraoperative findings of the study regarding regarding time taken for respective device insertion, effective seal, fiberoptic view of larynx, ease of Ryle's tube insertion, and postoperative sore throat assessment. Postoperative assessment of sore throat was done by blinded anesthesia resident.

RESULTS

The time required for insertion of i-gel was lesser (21.98 ± 5.42 and 30.60 ± 8.51 s in Group I and Group P, respectively; P = 0.001). Numbers of attempts for successful insertions were comparable and in majority, device was inserted in first attempt. The mean airway leak pressures were comparable. However, there were more number of patients in Group P who had airway leak pressure >20 cm H2O. The fiberoptic view of glottis, ease of Ryle's tube insertion, and incidence of complications were comparable.

CONCLUSION

Time required for successful insertion of i-gel was less in adult patients undergoing short surgical procedure under general anesthesia on spontaneous ventilation. Patients with airway leak pressure >20 cm H2O were more in PLMA group which indicates its better suitability for controlled ventilation.

摘要

背景

我们比较了i-gel喉罩和ProSeal喉罩气道(PLMA)在插入时间、有效密封、喉镜光纤视野、鼻胃管插入的难易程度以及术后咽痛评估等方面的情况。

材料与方法

以前瞻性、随机的方式,将48例年龄在18至60岁之间、美国麻醉医师协会分级为I-II级、拟行短小手术的成年患者,分配接受全身麻醉下自主通气的手术,使用i-gel喉罩或PLMA。一位经验丰富的非盲麻醉医师采用标准插入技术为患者插入合适尺寸的i-gel喉罩或PLMA,并评估研究的术中结果,包括各自设备的插入时间、有效密封、喉镜光纤视野、鼻胃管插入的难易程度以及术后咽痛评估。术后咽痛评估由盲法麻醉住院医师进行。

结果

i-gel喉罩的插入时间较短(I组和P组分别为21.98±5.42秒和30.60±8.51秒;P = 0.001)。成功插入的尝试次数相当,且大多数情况下,设备在首次尝试时就插入成功。平均气道漏气压力相当。然而,P组中气道漏气压力>20 cm H2O的患者更多。声门的光纤视野、鼻胃管插入的难易程度以及并发症的发生率相当。

结论

在全身麻醉下自主通气进行短小手术的成年患者中,成功插入i-gel喉罩所需的时间较短。PLMA组中气道漏气压力>20 cm H2O的患者更多,这表明其更适合控制通气。

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