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儿童使用i-gel(™)气道的评估:一项荟萃分析。

Evaluation of i-gel(™) airway in children: a meta-analysis.

作者信息

Maitra Souvik, Baidya Dalim K, Bhattacharjee Sulagna, Khanna Puneet

机构信息

Department of Anaesthesia and Intensive Care, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Paediatr Anaesth. 2014 Oct;24(10):1072-9. doi: 10.1111/pan.12483. Epub 2014 Jul 16.

Abstract

BACKGROUND

I-gel(™) is a relatively newer addition in the pediatric anesthesia practice. Its comparison with the other laryngeal mask airway repor-ted a wide range of results. Randomized controlled trials where i-gel(™) has been compared with other laryngeal masks (laryngeal mask airway ProSeal(™) and laryngeal mask airway Classic(™) ) in children for airway management device during general anesthesia has been included in this meta-analysis.

METHODS

PubMed and Central Register of Clinical Trials of the Cochrane Collaboration for eligible controlled trials using following search words: 'i-gel', 'i-gel laryngeal mask airway', 'i-gel children', 'i-gel paediatric' until February 15, 2014. A total nine prospective randomized controlled trials have been included in this meta-analysis.

RESULTS

Pooled analyses have found that i-gel(™) provided significantly higher oropharyngeal leak pressure than laryngeal mask airway ProSeal(™) [496 participants, mean difference 2.07 cm H2 O, 95% CI 0.52-3.62; P = 0.009] and a similar leak in comparison with laryngeal mask airway Classic(™) [355 participants, mean difference 1.73 cm H2 O, 95% CI -0.04, 3.51 cm H2 O; P =0.06]. No difference was found in first insertion success rate and ease of insertion between i-gel(™) , laryngeal mask airway ProSeal(™) , and laryngeal mask airway Classic(™) . Ease of gastric tube insertion is similar between i-gel(™) and laryngeal mask airway ProSeal(™) . Reported complications are infrequent and similar in all three devices.

CONCLUSION

We conclude that i-gel(™) is an effective alternative of the commonly used laryngeal mask airway ProSeal(™) and laryngeal mask airway Classic(™) in children for airway management during general anesthesia.

摘要

背景

I-gel(™)是小儿麻醉实践中相对较新的一种产品。其与其他喉罩气道的比较结果差异很大。本荟萃分析纳入了在全身麻醉期间将I-gel(™)与其他喉罩(ProSeal喉罩气道(™)和Classic喉罩气道(™))用于儿童气道管理设备的随机对照试验。

方法

截至2014年2月15日,在PubMed和Cochrane协作网临床试验中央注册库中检索符合条件的对照试验,使用以下检索词:“I-gel”、“I-gel喉罩气道”、“I-gel儿童”、“I-gel儿科”。本荟萃分析共纳入了9项前瞻性随机对照试验。

结果

汇总分析发现,I-gel(™)的口咽漏气压明显高于ProSeal喉罩气道(™)[496名参与者,平均差值2.07 cm H₂O,95%置信区间0.52 - 3.62;P = 0.009],与Classic喉罩气道(™)相比漏气压相似[355名参与者,平均差值1.73 cm H₂O,95%置信区间-0.04,3.51 cm H₂O;P = 0.06]。I-gel(™)、ProSeal喉罩气道(™)和Classic喉罩气道(™)在首次插入成功率和插入难易程度上没有差异。I-gel(™)和ProSeal喉罩气道(™)在胃管插入难易程度上相似。报告的并发症很少,且在这三种设备中相似。

结论

我们得出结论,在全身麻醉期间用于儿童气道管理时,I-gel(™)是常用的ProSeal喉罩气道(™)和Classic喉罩气道(™)的有效替代品。

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