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介入性支气管镜检查术中的麻醉管理:喉罩气道还是硬质支气管镜。

Anaesthesia Management During Interventional Bronchoscopic Procedures: Laryngeal Mask Airway or Rigid Bronchoscope.

作者信息

Fadaizadeh Lida, Hoseini Mahsa Sadat, Bagheri Mohammad

机构信息

Telemedicine Research Center, National Institute of Tuberculosis and Lung Disaeses, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Turk J Anaesthesiol Reanim. 2014 Dec;42(6):302-7. doi: 10.5152/TJAR.2014.85579. Epub 2014 Dec 1.

Abstract

OBJECTIVE

Interventional bronchoscopy procedures are novel and effective modes of diagnosing and treating airway lesions. Airway management and ventilation are a major concern, especially when considering the fire hazard of ventilating during endobronchial thermal therapies. The aim of this study was to evaluate the usage of laryngeal mask airway (LMA) compared to rigid bronchoscopy for the ventilation of patients undergoing diagnostic or therapeutic interventional bronchoscopy procedures.

METHODS

During this prospective randomised clinical trial study, patients were randomly allocated to two groups for ventilation: LMA and rigid bronchoscopy. Vital signs, including blood pressure, heart rate and percentage of blood O2 saturation before and during the procedure, degree of sore throat after recovery and physician's satisfaction, were recorded.

RESULTS

A total of 83 patients, including 45 in the "LMA" and 38 in the "rigid" groups, were enrolled in this study. Their mean age was 51±17 years, and 59 (71%) were male. There was a statically significant difference between "rigid" and "LMA" categories regarding the decrease in O2 during the procedure in proportion to baseline figures (p=0.028). Haemodynamic parameters were better maintained using LMA compared to rigid bronchoscopy.

CONCLUSION

Laryngeal mask ventilation maintains better oxygenation and haemodynamic stability and ensures physicians' and patients' satisfaction regarding ease of use, airway access and fewer complications compared to rigid bronchoscopy. Therefore, LMA can be introduced as a reliable alternative for ventilation during interventional airway procedures.

摘要

目的

介入性支气管镜检查是诊断和治疗气道病变的新型有效方式。气道管理和通气是主要关注点,尤其是考虑到支气管内热疗期间通气的火灾风险时。本研究的目的是评估与硬质支气管镜相比,喉罩气道(LMA)在接受诊断性或治疗性介入支气管镜检查的患者通气中的应用情况。

方法

在这项前瞻性随机临床试验研究中,患者被随机分为两组进行通气:LMA组和硬质支气管镜组。记录生命体征,包括手术前和手术期间的血压、心率和血氧饱和度百分比、恢复后喉咙疼痛程度以及医生满意度。

结果

本研究共纳入83例患者,其中“LMA”组45例,“硬质”组38例。他们的平均年龄为51±17岁,59例(71%)为男性。“硬质”组和“LMA”组在手术期间氧气相对于基线值的下降比例方面存在统计学显著差异(p = 0.028)。与硬质支气管镜相比,使用LMA能更好地维持血流动力学参数。

结论

与硬质支气管镜相比,喉罩通气能更好地维持氧合和血流动力学稳定性,并确保医生和患者对其易用性、气道通路及较少并发症方面的满意度。因此,LMA可作为介入性气道手术期间通气的可靠替代方法引入。

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