Department of Anaesthesiology, Herlev Hospital, Copenhagen, Denmark.
University of Copenhagen, Denmark.
Anaesthesia. 2019 Feb;74(2):151-157. doi: 10.1111/anae.14443. Epub 2018 Oct 4.
Indications for using supraglottic airway devices have widened over time and they now hold a prominent role in guidelines for difficult airway management. We aimed to describe the use of supraglottic airway devices in difficult airway management. We included adult patients undergoing general anaesthesia registered in the Danish Anaesthesia Database from 2008 to 2012 whose airway management had been recorded as difficult, defined as: ≥ 3 tracheal intubation attempts; failed tracheal intubation; or difficult facemask ventilation. In the Danish Anaesthesia Database, a separate difficult airway management module requires the technique used in each successive airway management attempt to be recorded. The primary aim of the study was to describe the use of supraglottic airway devices in cases of difficult airway management. Secondary aims were to examine success rates of supraglottic airway devices in difficult airway management cases, and specifically in the cases of 'cannot intubate, cannot facemask ventilate'. Difficult airway management occurred in 4898 (0.74% (95%CI 0.72-0.76%)) of 658,104 records of general anaesthesia. Supraglottic airway devices were used or use was attempted in 607 cases of difficult airway management (12.4% (95%CI 11.5-13.3%)), and were successful in 395 (65.1% (95%CI 61.2-68.8%)) cases. In 'cannot intubate, cannot facemask ventilate' situations, supraglottic airway devices were used in 86 (18.9% (95%CI 15.6-22.8%)) of 455 records and were successful in 54 (62.8% (95%CI 52.2-72.3%)) cases. We found that supraglottic airway devices are not widely used in the management of the difficult airway despite their prominent role in difficult airway management guidelines.
适应证随着时间的推移而扩大，在困难气道管理指南中，声门上气道装置现在占有突出地位。我们旨在描述声门上气道装置在困难气道管理中的应用。我们纳入了 2008 年至 2012 年期间在丹麦麻醉数据库中登记的接受全身麻醉的成年患者，这些患者的气道管理被记录为困难，定义为：≥3 次气管插管尝试；气管插管失败；或困难面罩通气。在丹麦麻醉数据库中，一个单独的困难气道管理模块要求记录每次连续气道管理尝试中使用的技术。研究的主要目的是描述声门上气道装置在困难气道管理中的应用。次要目的是检查声门上气道装置在困难气道管理病例中的成功率，特别是在“不能插管，不能面罩通气”的病例中。在 658104 例全身麻醉记录中，有 4898 例（0.74%（95%CI 0.72-0.76%））发生困难气道管理。在 607 例困难气道管理病例中使用或尝试使用了声门上气道装置（12.4%（95%CI 11.5-13.3%）），其中 395 例（65.1%（95%CI 61.2-68.8%））成功。在“不能插管，不能面罩通气”的情况下，在 455 例记录中使用了声门上气道装置 86 例（18.9%（95%CI 15.6-22.8%）），其中 54 例（62.8%（95%CI 52.2-72.3%））成功。我们发现，尽管声门上气道装置在困难气道管理指南中占有突出地位，但在困难气道管理中并未广泛使用。
