Park Sang Yoong, Rim Jong Cheol, Kim Hyuk, Lee Ji Hyeon, Chung Chan Jong
Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea.
Korean J Anesthesiol. 2015 Oct;68(5):455-61. doi: 10.4097/kjae.2015.68.5.455. Epub 2015 Sep 30.
In laparoscopic surgical procedures, many clinicians recommend supraglottic airway devices as good alternatives to intubation. We compared the i-gel® (i-gel) and LMA Supreme® (Supreme Laryngeal Mask Airway, SLMA) airway devices during laparoscopic cholecystectomy regarding sealing pressure and respiratory parameters before, during, and after pneumoperitoneum.
Following Institutional Review Board approval and written informed consent, 93 patients were randomly allocated into the i-gel (n = 47) or SLMA group (n = 46). Insertion time, number of insertion attempts, and fiberoptic view of glottis were recorded. Oropharyngeal leak pressure (OLP), the use of airway manipulation, peak inspiratory pressure, lung compliance, and hemodynamic parameters were measured before, during, and after pneumoperitoneum.
There were no significant differences between the two groups regarding demographic data, insertion time, fiberoptic view of glottis, and the use of airway manipulation. The gastric tube insertion time was longer in the i-gel group (20.4 ± 3.9 s) than in the SLMA group (16.7 ± 1.6 s) (P < 0.001). All devices were inserted on the first attempt, excluding one case in each group. Peak inspiratory pressure, lung compliance, and OLP changed following carbon dioxide pneumoperitoneum in each group, but there were no significant differences between the groups.
Both the i-gel and SLMA airway devices can be comparably used in patients who undergo laparoscopic cholecystectomy, and they offer similar performance including OLP.
在腹腔镜手术中,许多临床医生推荐声门上气道装置作为气管插管的良好替代方案。我们在腹腔镜胆囊切除术期间,比较了i-gel®(i-gel)和LMA Supreme®(喉罩气道,SLMA)气道装置在气腹前、气腹期间和气腹后的密封压力及呼吸参数。
经机构审查委员会批准并获得书面知情同意后,93例患者被随机分为i-gel组(n = 47)或SLMA组(n = 46)。记录插入时间、插入尝试次数和声门的纤维喉镜视野。在气腹前、气腹期间和气腹后测量口咽漏气压(OLP)、气道操作的使用情况、吸气峰压、肺顺应性和血流动力学参数。
两组在人口统计学数据、插入时间、声门的纤维喉镜视野和气道操作的使用方面无显著差异。i-gel组的胃管插入时间(20.4 ± 3.9秒)比SLMA组(16.7 ± 1.6秒)长(P < 0.001)。每组除1例患者外,所有装置均一次插入成功。每组中二氧化碳气腹后吸气峰压、肺顺应性和OLP均发生变化,但两组间无显著差异。
i-gel和SLMA气道装置在接受腹腔镜胆囊切除术的患者中均可同等使用,且它们具有相似的性能,包括OLP。