Maitra Souvik, Baidya Dalim K, Bhattacharjee Sulagna, Khanna Puneet
Department of Anaesthesia and Intensive Care, All India Institute of Medical Sciences, New Delhi, India.
Paediatr Anaesth. 2014 Oct;24(10):1072-9. doi: 10.1111/pan.12483. Epub 2014 Jul 16.
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.
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.
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.
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.
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。
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。
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。
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。