Boroda Nickolas, Malesinska Monika, Kars Michelle S, Smith Lee P
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY 11549, USA.
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY 11549, USA; Department of Anesthesiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY 11549, USA; Division of Pediatric Otolaryngology, Steven and Alexandra Cohen Children's Medical Center of New York, 430 Lakeville Road, New Hyde Park, NY 11042, USA.
Int J Pediatr Otorhinolaryngol. 2018 Apr;107:42-44. doi: 10.1016/j.ijporl.2018.01.034. Epub 2018 Jan 31.
Airway management during adenoidectomy is traditionally performed through endotracheal intubation (ETT). Laryngeal mask airway (LMA) may be less stimulating to the airway and allow for shorter overall operating room time. Previous studies report LMA use during adenotonsillectomy. There has been no prior evaluation of LMA use during adenoidectomy alone. In this study, we attempt to identify the rate and contributing factors of LMA failure during adenoidectomy.
All pediatric patients undergoing adenoidectomy between January 1, 2016 and June 30, 2017 were reviewed. Demographic and clinical data were collected and analyzed to determine the need for conversion to ETT and the occurrence of any complications.
Our study revealed 139 pediatric patients who underwent adenoidectomy during the study period. 110 patients had adenoidectomy performed with LMA and 27 patients had ETT. Two patients (1.8%) required conversion to ETT because of difficulty with ventilation when the mouth gag was in place. There were no complications. Mean operating room time was 20 min less in the LMA group (P < 0.05).
The use of an LMA in adenoidectomy may be a safe and effective alternative to ETT. More study is required to determine overall complication rates.
传统上腺样体切除术的气道管理是通过气管内插管（ETT）进行的。喉罩气道（LMA）对气道的刺激可能较小，并且可使总的手术室时间更短。先前的研究报道了在腺样体扁桃体切除术中使用LMA。此前尚无单独在腺样体切除术中使用LMA的评估。在本研究中，我们试图确定腺样体切除术中LMA失败的发生率及相关因素。
回顾了2016年1月1日至2017年6月30日期间所有接受腺样体切除术的儿科患者。收集并分析人口统计学和临床数据，以确定转为ETT的必要性及任何并发症的发生情况。
我们的研究显示，在研究期间有139例儿科患者接受了腺样体切除术。110例患者使用LMA进行腺样体切除术，27例患者使用ETT。2例患者（1.8%）因置入开口器时通气困难而需要转为ETT。无并发症发生。LMA组的平均手术室时间短20分钟（P<0.05）。
在腺样体切除术中使用LMA可能是一种安全有效的替代ETT的方法。需要更多研究来确定总体并发症发生率。
