Komasawa Nobuyasu, Nishihara Isao, Tatsumi Shinichi, Minami Toshiaki
Department of Anaesthesiology, Osaka Medical College, Takatsuki, Osaka, Japan.
Department of Anaesthesiology, Hokusetsu General Hospital, Takatsuki, Osaka, Japan.
BMJ Open. 2015 Jan 13;5(1):e006653. doi: 10.1136/bmjopen-2014-006653.
This study aimed to test the hypothesis that the i-gel supraglottic airway device would fit the larynx and provide better sealing pressure if prewarmed to 42°C relative to the device kept at room temperature in non-paralysed, sedated patients.
A total of 74 adult patients were assigned to the warm (i-gel prewarmed to 42°C; W group; 37 patients) or the control (i-gel kept at room temperature; C group; 37 patients) groups. Anaesthesia was induced with propofol and fentanyl. The i-gel was prewarmed to 42°C for 30 min before insertion in the W group, but kept at room temperature (approximately 23°C) for the C group. The number of attempts made until successful insertion and sealing pressure were compared between the two groups.
Insertion was successful with one attempt in 35 cases each for the W and C groups. Two attempts were needed in two cases for the W group and one case for the C group. There was one failed attempt in the C group, but none in the W group. None of the differences between the two groups were significant (p=0.51). Sealing pressure was slightly, but not significantly, higher in the W group than in the C group (W group 22.6±6.1 cm H2O; C group 20.7±6.1 cm H2O; p=0.15).
Prewarming of the i-gel to 42°C did not increase the success rate of insertion, nor did it significantly increase sealing pressure in anaesthetised, non-paralysed patients. Our data suggest that we can keep the i-gel at room temperature for emergency airway management for non-paralysed, sedated patients.
University Medical Information Network, Japan 000012287.
本研究旨在验证以下假设：对于未行气管插管、处于镇静状态的患者，与在室温下使用的i-gel声门上气道装置相比，预加热至42°C的该装置能更好地贴合喉部并提供更高的密封压力。
将74例成年患者分为加温组（i-gel预加热至42°C；W组，37例患者）和对照组（i-gel保存在室温下；C组，37例患者）。采用丙泊酚和芬太尼诱导麻醉。W组在插入i-gel前将其预加热至42°C并保持30分钟，而C组则将其保存在室温（约23°C）。比较两组直至成功插入所需的尝试次数和密封压力。
W组和C组各有35例患者一次插入成功。W组有2例患者需要进行两次尝试，C组有1例患者需要进行两次尝试。C组有1次插入失败，而W组无失败病例。两组之间的差异均无统计学意义（p=0.51）。W组的密封压力略高于C组，但差异无统计学意义（W组22.6±6.1 cm H2O；C组20.7±6.1 cm H2O；p=0.15）。
将i-gel预加热至42°C并未提高插入成功率，也未显著增加麻醉状态下未行气管插管患者的密封压力。我们的数据表明，对于未行气管插管、处于镇静状态的患者，在紧急气道管理中可将i-gel保存在室温下。
日本大学医学信息网络000012287。
