Kang Fang, Li Juan, Chai XiaoQing, Yu JinGui, Zhang HuaMing, Tang ChaoLiang
*Department of Anesthesia, QiLu Hospital (Affiliated to Shandong University School of Medicine), Jinan, Shandong Province †Department of Anesthesia, Anhui Provincial Hospital (Affiliated to Anhui Medical University), Anhui Province, China.
J Neurosurg Anesthesiol. 2015 Jan;27(1):37-41. doi: 10.1097/ANA.0000000000000088.
The single-use supreme-laryngeal mask airway (LMA) [corrected] has been reported to be suitable for airway management in the prone position. However, there are a limited number of cases using the I-gel in the prone position. In this study, we compared the clinical use of the 2 devices in adult patients undergoing elective lumbar vertebral surgery in the prone position.
Two hundred and sixty-four consecutive patients scheduled for lumbar surgery in the prone position were randomized to receive either the I-gel or the LMA [corrected] for airway management. All I-gels and LMAs [corrected] were inserted in the supine position by experienced anesthesiologists using standard techniques. Time and number of attempts needed for insertion, quality of ventilation, airway peak pressure, airway seal pressure, fiberoptic view, and complications were compared between the 2 groups.
No differences were observed in insertion time between groups. The I-gel required significantly more attempts at insertion (P<0.001). Airway seal pressure was lower in prone than in supine position in both groups (P<0.001). The I-gels provided a higher airway seal pressure ([28.4±5.4] vs. [24.8±4.6] cm H2O; P<0.001) in the prone position. There was no difference observed in fiberoptic view of the vocal cords between the 2 groups. The complication rate was low and was similar between the groups. There was little fluid in the mask of both the I-gel and the LMA [corrected] and the pH value was 6.8±0.7 versus 6.6±0.9, respectively.
The I-gel laryngeal mask airway can also be used safely in airway management of patients undergoing lumbar surgery in the prone position as well as the LMA [corrected].
据报道，一次性使用的上喉部面罩气道（LMA）[已修正]适用于俯卧位气道管理。然而，在俯卧位使用I-gel的病例数量有限。在本研究中，我们比较了这两种装置在接受择期腰椎手术的成年俯卧位患者中的临床应用情况。
连续264例计划在俯卧位进行腰椎手术的患者被随机分配接受I-gel或LMA[已修正]进行气道管理。所有I-gel和LMA[已修正]均由经验丰富的麻醉医生在仰卧位使用标准技术插入。比较两组之间插入所需的时间和尝试次数、通气质量、气道峰值压力、气道密封压力、纤维喉镜视野及并发症情况。
两组之间插入时间无差异。I-gel插入时所需的尝试次数明显更多（P<0.001）。两组中俯卧位时的气道密封压力均低于仰卧位（P<0.001）。在俯卧位时，I-gel的气道密封压力更高（[28.4±5.4]对[24.8±4.6]cmH₂O；P<0.001）。两组之间声带的纤维喉镜视野无差异。并发症发生率较低且两组相似。I-gel和LMA[已修正]面罩内的液体均很少，pH值分别为6.8±0.7和6.6±0.9。
I-gel喉罩气道在俯卧位接受腰椎手术患者的气道管理中也可像LMA[已修正]一样安全使用。
