Nisi Fulvio, Galzerano Antonio, Cicchitto Gaetano, Puma Francesco, Peduto Vito Aldo
Department of Anesthesiology, Intensive Care and Pain Therapy Centre, Perugia, Italy.
Department of Pneumology and Respiratory Medicine, AO Santa Maria della Misericordia, Perugia, Italy.
Med Devices (Auckl). 2015 Apr 30;8:201-6. doi: 10.2147/MDER.S77995. eCollection 2015.
There are still no clear guidelines in the literature on per procedural bronchoscopic management for anesthesiologists, and few relevant datasets are available. To obtain rapid recovery from anesthesia, it is often necessary to keep patients in the recovery room for several hours until they become clinically stable. In this study, we tested the hypothesis that the laryngeal mask airway (LMA) enables better respiratory and hemodynamic recovery than the oxygen face mask (FM) in patients undergoing rigid bronchoscopy.
Twenty-one patients undergoing elective bronchoscopy of the upper airway were randomized to ventilation assistance with FM or LMA after a rigid bronchoscopy procedure under general anesthesia. The primary endpoint was duration of post-surgical recovery and the secondary endpoints were postoperative hemodynamic and respiratory parameters. Assessment of the study endpoints was performed by an intensive care specialist blinded to the method of ventilation used. The statistical analysis was performed using the Fisher's Exact test for nominal data and the Student's t-test for continuous data.
There was no statistically significant difference in post-procedural time between the two groups (P=0.972). The recovery parameters were significantly better in the LMA group than in the FM group, with significantly fewer desaturation, hypotensive, and bradycardic events (P<0.05).
We conclude that the LMA may be safer and more comfortable than the FM in patients undergoing rigid bronchoscopy.
文献中仍没有针对麻醉医生的关于支气管镜检查过程中管理的明确指南,且可用的相关数据集很少。为了使患者从麻醉中快速恢复,通常有必要让患者在恢复室待几个小时,直到他们临床状况稳定。在本研究中,我们检验了这样一个假设:在接受硬质支气管镜检查的患者中,喉罩气道(LMA)比氧气面罩(FM)能实现更好的呼吸和血流动力学恢复。
21例接受择期上气道支气管镜检查的患者在全身麻醉下进行硬质支气管镜检查后,被随机分为接受FM或LMA通气辅助的两组。主要终点是术后恢复持续时间,次要终点是术后血流动力学和呼吸参数。由对所使用的通气方法不知情的重症监护专家对研究终点进行评估。使用Fisher精确检验分析名义数据,使用Student t检验分析连续数据。
两组术后时间无统计学显著差异(P = 0.972)。LMA组的恢复参数明显优于FM组,出现血氧饱和度降低、低血压和心动过缓事件的次数明显更少(P < 0.05)。
我们得出结论,对于接受硬质支气管镜检查的患者,LMA可能比FM更安全、更舒适。