Zhi Juan, Deng Xiao-Ming, Yang Dong, Wen Chao, Xu Wen-Li, Wang Lei, Xu Jin
Department of Anesthesiology,Plastic Surgery Hospital,CAMS and PUMC, Beijing 100144,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2016 Dec 20;38(6):637-642. doi: 10.3881/j.issn.1000-503X.2016.06.003.
Objective To compare the Ambu Aura-i with the Air-Q intubating laryngeal airway for fiberoptic-guided tracheal intubation in ear deformity children.Methods Totally 120 children who were scheduled for elective auricular reconstruction surgery requiring general anaesthesia with tracheal intubation were enrolled in this prospective study. They were randomized to receive either the Ambu Aura-i (Aura-i group) or Air-Q (Air-Q group). The time for successful tracheal intubation was assessed. The attempts for successful device insertion, leak pressures, cuff pressures, fiberoptic grade of laryngeal view, time for removal of the device after endotracheal intubation, and complications were recorded. Results Device placement, endotracheal intubation, and removal after endotracheal intubation were successful in all patients. The Air-Q group required longer time than the Aura-i group in device placement[(14.1±7.2) s vs. (10.8±5.2) s, P<0.05], successful endotracheal intubation [(39.8±9.5) s vs. (24.1±8.2) s, P<0.05], and device removal [(18.2±5.1) s vs. (14.7±3.7) s, P<0.05]. There were no differences in fiberoptic grade of view between these devices, and the percentage of glottis seen was 80.0% (Air-Q group) vs. 86.7% (Aura-i group). The leak pressure was (20.5±4.8) cmHO in the Air-Q group and (22.2±5.0) cmHO in the Aura-i group (P<0.05), and the cuff pressure was (22.9±11.5)cmHO in the Air-Q group and (33.9±15.9) cmHO in the Aura-i group (P<0.05). Hemodynamic changes were not significantly different between two group. The incidence rate of sore throat two hours after operation was 6.5% (n=4) in the Air-Q group and 5% (n=3) in the Aura-i group. Conclusion Both Ambu Aura-i and Air-Q intubating laryngeal airway are effective conduits for beroptic-guided tracheal intubation, with advantages including simple operation, high success rate, and fewer complications, especially the Ambu Aura-i.
目的 比较Ambu Aura-i与Air-Q气管插管喉罩在耳部畸形患儿纤维支气管镜引导下气管插管中的应用效果。方法 本前瞻性研究纳入120例择期行耳廓重建手术且需全身麻醉气管插管的患儿。将其随机分为Ambu Aura-i组(Aura-i组)和Air-Q组(Air-Q组)。评估成功气管插管的时间。记录成功插入装置的尝试次数、漏气压力、套囊压力、纤维支气管镜下喉镜视野分级、气管插管后取出装置的时间及并发症。结果 所有患者装置置入、气管插管及气管插管后取出均成功。Air-Q组在装置置入[(14.1±7.2)s比(10.8±5.2)s,P<0.05]、成功气管插管[(39.8±9.5)s比(24.1±8.2)s,P<0.05]及装置取出[(18.2±5.1)s比(14.7±3.7)s,P<0.05]方面所需时间均长于Aura-i组。两种装置在纤维支气管镜视野分级上无差异,声门可见率Air-Q组为80.0%,Aura-i组为86.7%。Air-Q组漏气压力为(20.5±4.8)cmH₂O,Aura-i组为(22.2±5.0)cmH₂O(P<0.05);Air-Q组套囊压力为(22.9±11.5)cmH₂O,Aura-i组为(33.9±15.9)cmH₂O(P<0.05)。两组血流动力学变化无显著差异。术后2小时咽痛发生率Air-Q组为6.5%(n=4),Aura-i组为5%(n=3)。结论 Ambu Aura-i和Air-Q气管插管喉罩均是纤维支气管镜引导下气管插管的有效管道,具有操作简单、成功率高、并发症少等优点,尤其是Ambu Aura-i。