Darlong Vanlal, Biyani Ghansham, Baidya Dalim K, Pandey Ravindra, Punj Jyotsna, Upadhyay Ashish D
Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Paediatr Anaesth. 2015 Aug;25(8):795-800. doi: 10.1111/pan.12663. Epub 2015 Apr 27.
The air-Q is a new supraglottic airway device (SAD) and has been increasingly used as a primary airway device and as a conduit for tracheal intubation in children as well as in adults. This device has either performed equally or better than other SADs in children. The Ambu Aura-i is a commonly used SAD in children undergoing various short surgical procedures. However, limited literature is available evaluating the safety and efficacy of the air-Q and the Ambu Aura-i in small children. We, therefore, conducted this study to compare the clinical performance of these two airway devices in infants weighing up to 10 kg. Our hypothesis is that air-Q, due to its improved and larger cuff design will yield better airway seal pressures as compared with the Ambu Aura-i.
Sixty-four ASA I-II infants weighing <10 kg undergoing elective ophthalmic surgery were randomly assigned to receive either an air-Q or the Ambu Aura-i. After induction of general anesthesia (GA) and muscle relaxation, we measured oropharyngeal leak pressure (OLP) as the primary outcome. The secondary end points measured were time to insert, first insertion success rate, fiberoptic grade (FO) of laryngeal view and any other airway complications like trauma, laryngospasm, and desaturation.
The air-Q ILA provided significantly higher OLP as compared with the Ambu Aura-i [20.2 ± 4.6 cm H2 O, CI 18.55-21.88; vs 16.2 ± 5.6 cmH2 O, CI 14.27-18.25, P = 0.003; mean difference 4 ± 1.29 cm H2 O, CI 1.41-6.58]. However, the Ambu Aura-i required significantly less time for its insertion (14.6 ± 2.8 s, CI 13.66-15.70; vs 16.3 ± 1.5 s, CI 15.75-16.86, P = 0.005; mean difference 1.625 ± 0.56 s, CI 0.48-2.76). There were no differences in first insertion success rate, FO view, and postoperative complications.
We conclude that air-Q may be considered superior to Ambu Aura-i in infants for controlled ventilation as it provides higher airway sealing pressures.
Air-Q是一种新型声门上气道装置（SAD），在儿童及成人中越来越多地被用作主要气道装置及气管插管的通道。该装置在儿童中的表现与其他SAD相当或更优。Ambu Aura-i是在接受各种短小手术的儿童中常用的SAD。然而，评估Air-Q和Ambu Aura-i在幼儿中的安全性和有效性的文献有限。因此，我们开展了本研究，比较这两种气道装置在体重达10kg的婴儿中的临床性能。我们的假设是，由于Air-Q改进且更大的套囊设计，与Ambu Aura-i相比，它将产生更好的气道密封压力。
64例体重<10kg、接受择期眼科手术的ASA I-II级婴儿被随机分配接受Air-Q或Ambu Aura-i。在全身麻醉（GA）诱导和肌肉松弛后，我们测量口咽漏气压（OLP）作为主要结局指标。测量的次要终点包括插入时间、首次插入成功率、喉镜视野的纤维光导分级（FO）以及任何其他气道并发症，如创伤、喉痉挛和血氧饱和度下降。
与Ambu Aura-i相比，Air-Q ILA提供的OLP显著更高[20.2±4.6cmH₂O，CI 18.55 - 21.88；vs 16.2±5.6cmH₂O，CI 14.27 - 18.25，P = 0.003；平均差异4±1.29cmH₂O，CI 1.4l - 6.58]。然而，Ambu Aura-i的插入时间显著更短（14.6±2.8秒，CI 13.66 - 15.70；vs 16.3±1.5秒，CI 15.75 - 16.86，P = 0.005；平均差异1.625±0.56秒，CI 0.48 - 2.76）。首次插入成功率、FO视野和术后并发症方面无差异。
我们得出结论，在婴儿中，Air-Q在控制通气方面可能优于Ambu Aura-i，因为它能提供更高的气道密封压力。
