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喉罩气道的优点、缺点、适应症、禁忌症及手术技术

Advantages, Disadvantages, Indications, Contraindications and Surgical Technique of Laryngeal Airway Mask.

作者信息

Jannu Anubhav, Shekar Ashim, Balakrishna Ramdas, Sudarshan H, Veena G C, Bhuvaneshwari S

机构信息

Department of Oral and Maxillofacial Surgery, Rajiv Gandhi University of Health Sciences, Bangalore, India.

出版信息

Arch Craniofac Surg. 2017 Dec;18(4):223-229. doi: 10.7181/acfs.2017.18.4.223. Epub 2017 Dec 23.

Abstract

The beauty of the laryngeal mask is that it forms an air tight seal enclosing the larynx rather than plugging the pharynx, and avoid airway obstruction in the oropharynx. The goal of its development was to create an intermediate form of airway management face mask and endotracheal tube. Indication for its use includes any procedure that would normally involve the use of a face mask. The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anesthetic practice. Despite wide spread use the definitive role of the laryngeal mask airway is yet to be established. In some situations, such as after failed tracheal intubation or in oral surgery its use is controversial. There are several unresolved issues, for example the effect of the laryngeal mask on regurgitation and whether or not cricoids pressure prevents placement of mask. We review the techniques of insertion, details of misplacement, and complications associated with use of the laryngeal mask. We then attempt to clarify the role of laryngeal mask in air way management during anesthesia, discussing the advantages and disadvantages as well as indications and contraindications of its use in oral and maxillofacial surgery.

摘要

喉罩的优点在于它能形成一个密封环绕喉部的气密装置,而非堵塞咽部,从而避免口咽气道梗阻。其研发目的是创造一种介于面罩和气管内导管之间的气道管理方式。其使用指征包括任何通常会用到面罩的操作。喉罩气道被设计为气道管理的新概念,并在麻醉实践中占据了稳固地位。尽管已广泛使用,但喉罩气道的确切作用仍有待确定。在某些情况下,如气管插管失败后或口腔手术中,其使用存在争议。还有几个未解决的问题,例如喉罩对反流的影响以及环状软骨压迫是否会妨碍喉罩放置。我们回顾了喉罩的插入技术、放置错误的细节以及与使用喉罩相关的并发症。然后我们试图阐明喉罩在麻醉期间气道管理中的作用,讨论其在口腔颌面外科手术中使用的优缺点以及适应证和禁忌证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b9/5759658/2f61e489bc3d/acfs-18-223-g001.jpg

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