Balaban Onur, Kamata Mineto, Hakim Mumin, Tumin Dmitry, Tobias Joseph D
Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA.
J Anesth. 2017 Apr;31(2):278-281. doi: 10.1007/s00540-016-2297-8. Epub 2016 Dec 21.
Given the size of the esophagogastroduodenoscopy (EGD) probe and the compressibility of the pediatric airway, the EGD probe may increase the intracuff pressure (IP) of an airway device. The current study evaluated IP changes during EGD examination under general anesthesia in pediatric patients. Following the induction of anesthesia, a laryngeal mask airway (LMA) or endotracheal tube (ETT) was placed without neuromuscular blockade. The IP was measured at baseline, during EGD probe insertion, while the EGD probe was in place, and after probe removal. The study cohort included 101 patients (mean age 11.3 years). The airway was secured with an LMA and an ETT in 88 and 13 patients, respectively. The IP increased from 27 ± 15 cmHO at baseline to 34 ± 17 cmHO during probe insertion (p < 0.001), remained at 33 ± 16 cmHO while the probe was in place, and decreased to 26 ± 14 cmHO after probe removal. The IP of the LMA or ETT increased during EGD probe insertion and remained elevated while the probe was in place. High IP may compromise mucosal perfusion resulting in a sore throat when using an LMA or the potential for airway damage if an ETT is used. Removal of air from the cuff and titration of the IP should be considered after EGD insertion.
考虑到食管胃十二指肠镜检查（EGD）探头的尺寸以及小儿气道的可压缩性，EGD探头可能会增加气道装置的套囊内压力（IP）。本研究评估了小儿患者在全身麻醉下进行EGD检查期间的IP变化。麻醉诱导后，在未使用神经肌肉阻滞剂的情况下放置喉罩气道（LMA）或气管内导管（ETT）。在基线、EGD探头插入期间、EGD探头就位时以及探头移除后测量IP。研究队列包括101例患者（平均年龄11.3岁）。分别有88例和13例患者通过LMA和ETT确保气道安全。IP从基线时的27±15cmH₂O增加到探头插入期间的34±17cmH₂O（p<0.001），在探头就位时保持在33±16cmH₂O，探头移除后降至26±14cmH₂O。在EGD探头插入期间，LMA或ETT的IP增加，并且在探头就位时保持升高。高IP可能会损害黏膜灌注，使用LMA时会导致喉咙痛，使用ETT时则可能有气道损伤的风险。在EGD插入后应考虑从套囊中抽出空气并调整IP。
