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麻醉、瘫痪成年患者中一次性流线型咽气道衬垫与一次性I-gel的比较:一项随机前瞻性研究

Comparison of the Disposable Streamlined Liner of the Pharynx Airway and the Disposable I-gel in Anaesthetized, Paralyzed Adults: A Randomized Prospective Study.

作者信息

El-Radaideh Khaled, Alhowary Ala A, Bani Hani Diab

机构信息

Department of Anesthesiology, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 953, Irbid 21110, Jordan.

出版信息

Anesthesiol Res Pract. 2015;2015:971059. doi: 10.1155/2015/971059. Epub 2015 Dec 1.

Abstract

Introduction. This study compared streamlined liner of the pharynx airway (SLIPA) and I-gel noninflatable, single-use, supraglottic airway device (SAD) performance in anesthetized, paralyzed adults. Methods. Eighty adults (ASA physical statuses I-III) who were undergoing elective procedures under general anesthesia with an SAD were enrolled in this prospective, randomized, single-blind study. Subjects were randomly and evenly assigned to the SLIPA or I-gel group for intraoperative airway management. Ease and number of insertions, insertion time, oropharyngeal sealing pressure, hemodynamic response, oxygen saturation (SpO2), end-tidal CO2 (EtCO2), and peri- and postoperative complications were examined. Results. The SLIPA and I-gel devices were successfully inserted in 100% and 95% of subjects, respectively. In two I-gel subjects (5%), ventilation was not possible after two attempts, but a size 55 SLIPA was successfully inserted in both cases. Forty-two and 38 patients were ultimately included in the SLIPA and I-gel groups, respectively. Insertion time was significantly shorter with the SLIPA (11.19 ± 3.03 s) than with the I-gel (15.05 ± 6.37 s, P = 0.003). Oropharyngeal sealing pressure was significantly higher in SLIPA (28.76 ± 3.11 cmH2O) than in I-gel (25.9 ± 3.65 cmH2O) subjects (P = 0.001). Blood staining occurred more frequently in SLIPA (n = 8, 19.0%) than in I-gel (n = 5, 13.2%) patients (P < 0.01). Heart rate, mean arterial blood pressure, SpO2, and EtCO2 were not significantly different between groups. Conclusion. Although blood staining incidence was higher, SLIPA insertion was easier and faster than I-gel insertion. The SLIPA provided better airway sealing pressure. Both devices had similar mechanical ventilation and oxygenation characteristics and comparable hemodynamic stability. Both noninflatable SADs are useful, but SLIPA rapid insertion and good airway sealing make it an effective alternative to the I-gel.

摘要

引言。本研究比较了咽气道流线型喉罩(SLIPA)与I-gel一次性非充气声门上气道装置(SAD)在麻醉、瘫痪的成年患者中的性能。方法。80例美国麻醉医师协会(ASA)身体状况分级为I-III级、在全身麻醉下使用SAD进行择期手术的成年患者纳入了这项前瞻性、随机、单盲研究。将受试者随机且平均分配至SLIPA组或I-gel组进行术中气道管理。检查插入的难易程度和次数、插入时间、口咽密封压、血流动力学反应、血氧饱和度(SpO2)、呼气末二氧化碳分压(EtCO2)以及围手术期和术后并发症。结果。SLIPA和I-gel装置分别在100%和95%的受试者中成功插入。在两名I-gel受试者(5%)中,两次尝试后均无法通气,但在这两种情况下,均成功插入了55号的SLIPA。最终分别有42例和38例患者纳入SLIPA组和I-gel组。SLIPA的插入时间(11.19±3.03秒)显著短于I-gel(15.05±6.37秒,P = 0.003)。SLIPA组受试者的口咽密封压(28.76±3.11厘米水柱)显著高于I-gel组(25.9±3.65厘米水柱)(P = 0.001)。SLIPA组患者(n = 8,19.0%)的血染发生率高于I-gel组患者(n = 5,13.2%)(P < 0.01)。两组之间的心率、平均动脉血压、SpO2和EtCO2无显著差异。结论。尽管血染发生率较高,但SLIPA的插入比I-gel更容易、更快。SLIPA提供了更好的气道密封压。两种装置具有相似的机械通气和氧合特性以及相当的血流动力学稳定性。两种非充气SAD均有用,但SLIPA的快速插入和良好的气道密封使其成为I-gel的有效替代品。

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