Gupta Roshni, Mahajan Rajesh, Jatinder Mukta, Gulati Smriti, Mehta Anjali, Nazir Robina
Department of Anaesthesia and ICU, Government Medical College, Jammu, Jammu and Kashmir, India.
J Anaesthesiol Clin Pharmacol. 2019 Jul-Sep;35(3):340-347. doi: 10.4103/joacp.JOACP_397_17.
ProSeal laryngeal mask airway (PLMA) is an established device for airway management, while Air-Q Blocker (AQB) is a relatively new supraglottic device. The aim of this study is to compare AQB against PLMA in adults undergoing laparoscopic cholecystectomy under general anesthesia.
Eighty-eight adult patients scheduled for laparoscopic cholecystectomy under general anesthesia were randomly allocated into two groups. A drain tube (gastric tube for PLMA and blocker tube for AQB) was inserted through the drain channel of the respective device. PLMA was inserted in Group P ( = 44) and AQB was inserted in Group A ( = 44) to secure the airway. The primary endpoint was airway seal pressure. Secondarily, we sought to compare overall insertion success, ease of insertion, hemodynamic effects after initial placement, ease of drain tube placement, and perioperative oropharyngolaryngeal morbidity between the devices.
Oropharyngeal seal pressures for AQB and PLMA were 31.5 ± 2.41 and 29.41 ± 2.14 cm HO, respectively ( = 0.01). Insertion time was longer with AQB than PLMA, 25.59 ± 5.71 and 18.66 ± 3.15 seconds, respectively ( = 0.001). Ease and success rate of insertion was better with PLMA compared to AQB. Failure of device insertion was seen in 2 cases of Group A. Gastric distension was seen in 4 patients in Group A, requiring replacement with endotracheal tube in two patients. Ventilation was successful in all 44 patients with PLMA. Both the devices were comparable in providing a patent airway and adequate oxygenation during controlled ventilation. There was an increased trend of airway trauma and complications in the AQB group.
Both PLMA and AQB show similar efficacy in maintaining ventilation and oxygenation, during laparoscopic surgery. However, proper positioning and functioning of the blocker tube of AQB is a limiting factor, and needs further evaluation.
ProSeal喉罩气道（PLMA）是一种成熟的气道管理装置，而Air-Q封堵器（AQB）是一种相对较新的声门上装置。本研究的目的是在全身麻醉下行腹腔镜胆囊切除术的成人患者中比较AQB与PLMA。
88例计划在全身麻醉下行腹腔镜胆囊切除术的成年患者被随机分为两组。通过各自装置的引流通道插入一根引流管（PLMA用胃管，AQB用封堵管）。P组（n = 44）插入PLMA，A组（n = 44）插入AQB以确保气道安全。主要终点是气道密封压。其次，我们试图比较总体插入成功率、插入的难易程度、初次放置后的血流动力学效应、引流管放置的难易程度以及两种装置之间围手术期口咽喉发病率。
AQB和PLMA的口咽密封压分别为31.5±2.41和29.41±2.14 cm H₂O（P = 0.01）。AQB的插入时间比PLMA长，分别为25.59±5.71秒和18.66±3.15秒（P = 0.001）。与AQB相比，PLMA的插入难易程度和成功率更好。A组有2例装置插入失败。A组有4例患者出现胃扩张，其中2例需要更换为气管内插管。所有44例使用PLMA的患者通气均成功。在控制通气期间，两种装置在提供通畅气道和充分氧合方面具有可比性。AQB组气道创伤和并发症有增加趋势。
在腹腔镜手术期间，PLMA和AQB在维持通气和氧合方面显示出相似的疗效。然而，AQB封堵管的正确定位和功能是一个限制因素，需要进一步评估。
