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喉罩(i-gel™)与喉镜片(LMA Supreme™)在全麻且肌松患儿中的比较。

A comparison of i-gel™ and LMA Supreme™ in anesthetized and paralyzed children.

机构信息

Department of Anesthesiology and Pain Medicine, Dong-A University Hospital, Busan, Korea.

出版信息

Korean J Anesthesiol. 2014 Nov;67(5):317-22. doi: 10.4097/kjae.2014.67.5.317. Epub 2014 Nov 26.

Abstract

BACKGROUND

Both the i-gel™ (i-gel) and LMA Supreme™ (Supreme) are new single-use second generation supraglottic airway devices available in pediatric sizes. This study was designed to investigate the i-gel in comparison with the Supreme in children undergoing general anesthesia.

METHODS

One hundred children with American Society of Anesthesiologists physical status I or II undergoing general anesthesia were randomly assigned to either the i-gel or the Supreme group (50 children in each group). The device size was chosen according to weight of the children. We assessed the insertion success rate, insertion time, oropharyngeal leak pressure, grade of the fiberoptic glottic view, number of airway manipulations required, and postoperative complications.

RESULTS

There were no differences in the demographic data between the two groups. The success rate of insertion was same in both groups. The insertion time of the i-gel was longer than that of Supreme (P = 0.004). The oropharyngeal leak pressure in the i-gel group was higher than that in the Supreme group (P = 0.013). On fiberoptic examination, the vocal cords were visible in 90% of the children in the i-gel group and in 96% of the children in the Supreme group. The number of airway manipulations required was higher in the i-gel group (14 cases) than in the Supreme group (1 case) (P < 0.001). There were no differences in complications including blood staining of the device and sore throat between both groups.

CONCLUSIONS

Both the i-gel and Supreme provided a satisfactory airway during general anesthesia in children. Compared to the Supreme, the i-gel demonstrated a higher oropharyngeal leak pressure, longer time for insertion, and a greater number of airway manipulations during anesthesia.

摘要

背景

i-gel™(i-gel)和 LMA Supreme™(Supreme)均为新型一次性第二代喉上气道装置,均有小儿型号。本研究旨在比较这两种装置在小儿全身麻醉中的应用。

方法

100 例行全身麻醉的美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级的儿童,随机分为 i-gel 组或 Supreme 组(每组 50 例)。根据患儿体重选择装置型号。评估插入成功率、插入时间、经口漏气压、光纤喉镜下声门显露分级、需要的气道操作次数和术后并发症。

结果

两组患儿的一般资料比较差异无统计学意义。两组的插入成功率相同。i-gel 的插入时间长于 Supreme(P=0.004)。i-gel 组的经口漏气压高于 Supreme 组(P=0.013)。在纤维光镜下,i-gel 组 90%的患儿声带可见,而 Supreme 组为 96%。i-gel 组需要气道操作的次数高于 Supreme 组(14 例比 1 例)(P<0.001)。两组的并发症如装置血迹和咽痛比较差异无统计学意义。

结论

i-gel 和 Supreme 均能为小儿全身麻醉提供满意的气道。与 Supreme 相比,i-gel 具有更高的经口漏气压、更长的插入时间和更多的麻醉期间气道操作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a6f/4252343/e54a33d27f9c/kjae-67-317-g001.jpg

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