Katsiampoura Anastasia D, Killoran Peter V, Corso Ruggero M, Cai Chunyan, Hagberg Carin A, Cattano Davide
Department of Anesthesiology, University of Texas Medical Science Center, Houston, TX, USA.
Emergency Department, Anesthesia and Intensive Care Section, "GB Morgagni-L.Pierantoni" Hospital, Forli, 47121, Italy.
F1000Res. 2015 Apr 29;4:102. doi: 10.12688/f1000research.6415.1. eCollection 2015.
Laryngeal mask airway (LMA) placement is now considered a common airway management practice. Although there are many studies which focus on various airway techniques, research regarding difficult LMA placement is limited, particularly for anesthesiologist trainees. In our retrospective analysis we tried to identify predictive factors of difficult LMA placement in an academic training program.
This retrospective analysis was derived from a research airway database, where data were collected prospectively at the Memorial Hermann Hospital, Texas Medical Center, Houston, TX, USA, from 2008 to 2010. All non-obstetric adult patients presenting for elective surgery requiring general anesthesia, were enrolled in this study: anesthesiology residents primarily managed the airways. The level of difficulty, number of attempts, and type of the extraglottic device placement were retrieved.
Sixty-nine unique Laryngeal Mask Airways (uLMAs) were utilized as a primary airway device. Two independent predictors for difficult LMA placement were identified: gender and neck circumference. The sensitivity for one factor is 87.5% with a specificity of 50%. However with two risk factors, the specificity increases to the level of 93% and the sensitivity is 63%.
In a large academic training program, besides uLMA not been used routinely, two risk factors for LMA difficulty were identified, female gender and large neck circumference. Neck circumference is increasingly being recognized as a significant predictor across the spectrum of airway management difficulties while female gender has not been previously reported as a risk factor for difficult LMA placement.
喉罩气道（LMA）置入目前被视为一种常见的气道管理操作。尽管有许多研究聚焦于各种气道技术，但关于困难LMA置入的研究有限，尤其是对于麻醉学实习生而言。在我们的回顾性分析中，我们试图在一个学术培训项目中确定困难LMA置入的预测因素。
这项回顾性分析源自一个研究气道数据库，该数据库于2008年至2010年在美国得克萨斯州休斯顿市德克萨斯医学中心的纪念赫尔曼医院前瞻性收集数据。所有因择期手术需要全身麻醉的非产科成年患者均纳入本研究：气道主要由麻醉科住院医师管理。记录声门外装置置入的困难程度、尝试次数及类型。
69个独特的喉罩气道（uLMA）被用作主要气道装置。确定了两个困难LMA置入的独立预测因素：性别和颈围。单一因素的敏感性为87.5%，特异性为50%。然而，存在两个危险因素时，特异性增至93%，敏感性为63%。
在一个大型学术培训项目中，除未常规使用uLMA外，还确定了LMA置入困难的两个危险因素，即女性和颈围较大。颈围越来越被认为是气道管理困难的一个重要预测因素，而女性此前未被报道为困难LMA置入的危险因素。
