van Esch Babette F, Stegeman Inge, Smit Adriana L
Apeldoorn Dizziness Center Gelre Hospital, Apeldoorn, The Netherlands.
Department of Otorhinolaryngology, University Medical Center Utrecht, The Netherlands and Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands.
J Clin Anesth. 2017 Feb;36:142-150. doi: 10.1016/j.jclinane.2016.10.004. Epub 2016 Dec 3.
To determine whether the laryngeal mask airway (LMA) has advantages over the tracheal tube (TT) in terms of incidence of cough, sore throat, laryngospasm, dysphagia, dysphonia, and blood staining. This is a systematic literature review performed at the Universtity Medical Center of Utrecht. The online databases PubMed, Embase, and the Cochrane Library were searched for relevant randomized controlled trials. Two independent reviewers selected relevant articles after title, abstract, and full text screening. Articles were assessed on risk of bias in accordance with the Cochrane risk of bias tool. Study results of the LMA and the TT were related to the method of selection of the device size and the method for cuff inflation. Of the 1718 unique articles, we included 19 studies which used the LMA Classic, the LMA Proseal, the Flexible Reinforced LMA, and the LMA Supreme compared with TT. After methodological inspection, data could not be pooled due to heterogeneity among the selected studies. Overall, no clear advantage of the LMA over the TT was found but the LMA Supreme was related to the lowest incidence of airway complications. In this review, no clear difference in incidence of postoperative airway complications could be demonstrated between LMA and TT. The LMA Supreme may reduce the incidence of airway complication in comparison to the TT but high quality randomized trials are recommended to further objectify if use of the LMA decreases the risk on postoperative airway complications.
为了确定喉罩气道（LMA）在咳嗽、咽痛、喉痉挛、吞咽困难、发音障碍和血染发生率方面是否优于气管导管（TT）。这是一项在乌得勒支大学医学中心进行的系统文献综述。检索了在线数据库PubMed、Embase和Cochrane图书馆以查找相关的随机对照试验。两名独立的评审员在标题、摘要和全文筛选后选择相关文章。根据Cochrane偏倚风险工具对文章进行偏倚风险评估。LMA和TT的研究结果与设备尺寸的选择方法和套囊充气方法有关。在1718篇独特的文章中，我们纳入了19项研究，这些研究将LMA Classic、LMA Proseal、可弯曲加强型LMA和LMA Supreme与TT进行了比较。经过方法学检查，由于所选研究之间存在异质性，无法汇总数据。总体而言，未发现LMA相对于TT有明显优势，但LMA Supreme与气道并发症的最低发生率相关。在本综述中，未证明LMA和TT在术后气道并发症发生率上有明显差异。与TT相比，LMA Supreme可能会降低气道并发症的发生率，但建议进行高质量的随机试验，以进一步明确使用LMA是否会降低术后气道并发症的风险。
