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比较 LM-Supreme™ 喉镜片与气管导管在妇科腹腔镜手术中的应用。

Comparison of LM-Supreme™ and endotracheal tube in patients undergoing gynecological laparoscopic surgery.

机构信息

Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey.

出版信息

J Clin Monit Comput. 2020 Apr;34(2):295-301. doi: 10.1007/s10877-019-00310-2. Epub 2019 Apr 9.

DOI:10.1007/s10877-019-00310-2
PMID:30968326
Abstract

While laryngeal mask is widely used for laparoscopic interventions in some countries, concerns exist regarding pulmonary aspiration and inadequate ventilation. We compared the LM-Supreme™ (LM-S) with the endotracheal tube (ETT) for laparoscopic gynecological interventions in terms of ventilation parameters and gastric distention. This prospective randomized and double-blind study. The patients were divided into two groups: ETT (n = 50) and LM-S group (n = 50). All patients in the LM-S and ETT groups recieved total intravenous general anaesthesia and standard ventilation protocols. Ventilation parameters (airway peak pressure, mean airway pressure, end-tidal carbon dioxide, total volume, oropharyngeal leak pressure) and perioperative laryngopharyngeal morbidity were recorded before peritoneal insufflation, during and after the peroperative period. The mean airway pressure values in the ETT group 2 min after airway device insertion were significantly higher. The gastric distension after the laparoscope entered the abdomen in the LM-S group was found to be significantly lower. In the first hour postoperative sore throat, disphonia and dysphagia were statistically significantly higher in the ETT group. In our study we concluded that LM-S provides reliable endotracheal intubation in ASA I & II patients undergoing laparoscopic gynecological surgery under positive pressure ventilation.ClinicalTrials.gov ID NCT02127632.

摘要

虽然在一些国家,喉罩被广泛应用于腹腔镜介入,但仍存在肺吸入和通气不足的担忧。我们比较了 LM-Supreme™(LM-S)和气管内导管(ETT)在腹腔镜妇科手术中的通气参数和胃扩张情况。这是一项前瞻性随机双盲研究。患者分为两组:ETT 组(n=50)和 LM-S 组(n=50)。所有患者均接受全静脉全身麻醉和标准通气方案。在腹膜充气前、术中及术后期间记录通气参数(气道峰压、平均气道压、呼气末二氧化碳分压、总通气量、咽腔漏气压)和围手术期咽喉部并发症。ETT 组气道装置插入后 2 分钟时平均气道压显著升高。LM-S 组腹腔镜进入腹部后胃扩张明显降低。术后 1 小时,ETT 组的咽痛、声音嘶哑和吞咽困难发生率明显更高。在我们的研究中,我们得出结论,LM-S 可在正压通气下为 ASA I 和 II 级行腹腔镜妇科手术的患者提供可靠的气管插管。ClinicalTrials.gov ID NCT02127632。

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本文引用的文献

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Minerva Anestesiol. 2010 Aug;76(8):592-9. Epub 2010 Jun 18.
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Preparation of Supreme laryngeal mask airway affects insertion.
Anaesth Intensive Care. 2010 Jan;38(1):211-2.
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Prospective clinical and fiberoptic evaluation of the Supreme laryngeal mask airway.喉罩气道(Supreme)的前瞻性临床及纤维光学评估
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全麻下择期腹腔镜妇科手术中 64 例女性患者使用 Baska 口罩与气管插管的安全性和有效性:一项前瞻性单中心研究。
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