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比较喉罩气道、Cobra喉周气道和面罩在儿童气道管理中的应用

Comparing the Laryngeal Mask Airway, Cobra Perilaryngeal Airway and Face Mask in Children Airway Management.

作者信息

Tekin Beyza, Hatipoğlu Zehra, Türktan Mediha, Özcengiz Dilek

机构信息

Clinic of Anaesthesia, Çukurova Aşkım Tüfekçi State Hospital, Adana, Turkey.

Department of Anaesthesiology and Reanimation, Çukurova University School of Medicine, Adana, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2016 Apr;44(2):81-5. doi: 10.5152/TJAR.2016.19970. Epub 2016 Apr 1.

Abstract

OBJECTIVE

We compared the effects of the laryngeal mask airway (LMA), face mask and Cobra perilaryngeal airway (PLA) in the airway management of spontaneously breathing paediatric patients undergoing elective inguinal surgery.

METHODS

In this study, 90 cases of 1-14-year-old children undergoing elective inguinal surgery were scheduled. The patients were randomly divided into three groups. Anaesthesia was provided with sevoflurane and 50%-50% nitrous oxide and oxygen. After providing an adequate depth of anaesthesia, supraglottic airway devices were inserted in the group I and II patients. The duration and number of insertion, haemodynamic parameters, plateau and peak inspiratory pressure and positive end-expiratory pressure of the patients were recorded preoperatively, after induction and at 5, 10, 15 and 30 min peroperatively.

RESULTS

There were no statistical differences between the groups in terms of haemodynamic parameters (p>0.05). In group II, instrumentation success was higher and instrumentation time was shorter than group II. The positive end-expiratory pressure and plateau and peak inspiratory pressure values were statistically lower in group II (p<0.05).

CONCLUSION

We concluded that for airway safety and to avoid possible complications, LMA and Cobra PLA could be alternatives to face mask and that the Cobra PLA provided lower airway pressure and had a faster and more easy placement than LMA.

摘要

目的

我们比较了喉罩气道(LMA)、面罩和Cobra喉周气道(PLA)在择期腹股沟手术的自主呼吸儿科患者气道管理中的效果。

方法

在本研究中,计划纳入90例1 - 14岁接受择期腹股沟手术的儿童。患者被随机分为三组。采用七氟醚和50%-50%氧化亚氮与氧气进行麻醉。在达到足够的麻醉深度后,为I组和II组患者插入声门上气道装置。记录患者术前、诱导后以及术中5、10、15和30分钟时的插入持续时间和次数、血流动力学参数、平台压和吸气峰压以及呼气末正压。

结果

各组之间在血流动力学参数方面无统计学差异(p>0.05)。在II组中,器械置入成功率高于I组且置入时间短于I组。II组中的呼气末正压以及平台压和吸气峰压值在统计学上更低(p<0.05)。

结论

我们得出结论,为了气道安全并避免可能的并发症,LMA和Cobra PLA可作为面罩的替代方案,并且Cobra PLA能提供更低的气道压力且比LMA放置更快、更简便。

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[Update 2022: interdisciplinary statement on airway management with supraglottic airway devices in pediatric emergency medicine-The laryngeal mask is and remains state of the art : Joint statement of the Institute for Emergency Medicine and Medicine Management (INM), the University Clinic Munich, LMU Munich, Germany, the Working Group for Pediatric Critical Care and Emergency Medicine of the German Interdisciplinary Society for Critical Care and Emergency Medicine (DIVI), the Medical Directors of Emergency Medical Services in Bavaria (ÄLRD), the Scientific Working Group for Pediatric Anesthesia (WAKKA) of the German Society for Anesthesiology and Intensive Care Medicine (DGAI), the Scientific Working Group for Emergency Medicine of the German Society for Anesthesiology and Intensive Care Medicine (DGAI) and the Society of Neonatology and Pediatric Critical Care Medicine (GNPI)].[2022年更新:儿科急诊医学中使用声门上气道装置进行气道管理的跨学科声明——喉罩过去是、现在仍然是先进技术:德国慕尼黑大学急诊医学与医学管理研究所(INM)、德国慕尼黑大学大学医院、德国重症与急诊医学跨学科协会(DIVI)儿科重症监护与急诊医学工作组、巴伐利亚州紧急医疗服务医疗主任(ÄLRD)、德国麻醉与重症医学协会(DGAI)儿科麻醉科学工作组(WAKKA)、德国麻醉与重症医学协会(DGAI)急诊医学科学工作组以及新生儿与儿科重症医学协会(GNPI)联合声明]
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