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Baska喉罩与I-gel喉上气道装置的比较:一项随机对照研究。

Comparison of the Baska and I-gel supraglottic airway devices: a randomized controlled study.

作者信息

Kara Duygu, Sarikas Cafer Mutlu

机构信息

From the Department of Anesthesiology and Reanimation, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.

出版信息

Ann Saudi Med. 2019 Sep-Oct;39(5):302-308. doi: 10.5144/0256-4947.2019.302. Epub 2019 Oct 3.

Abstract

BACKGROUND

Laryngeal masks are increasingly used in place of endotracheal intubation or face masks for maintaining the airway during surgery.

OBJECTIVES

Compare the insertion time and other features of the Baska and I-gel masks in patients undergoing general anesthesia for urological surgery.

DESIGN

Randomized-controlled, single-blind study.

SETTINGS

Urology surgical operating rooms of a tertiary care hospital.

SUBJECTS AND METHODS

We enrolled concomitant patients whose surgery was expected to last less than two hours. Following premedication and adequate relaxation, subjects were randomly allocated to the I-gel mask or the Baska mask. Computer-generated random numbers were used for randomization with sealed opaque envelopes for allocation concealment.

MAIN OUTCOME MEASURES

The primary outcome measure of the study was the time required for laryngeal mask airway (LMA) insertion. Also, the number of device placement attempts, the number of postoperative signs and symptoms (cough, breath holding, laryngeal spasm, lip trauma, blood on the mask), and laryngopharyngeal morbidity scores at 1 and 24 hours postoperatively.

SAMPLE SIZE

211 met inclusion criteria, 200 participants completed the study.

RESULTS

Compared to I-gel, the Baska mask required a longer time for insertion, and its airway pressure was higher. The median (minimum-maximum) duration of LMA insertion in the Baska and I-gel groups was 14 (6-25) and 7 (5-12) seconds, respectively (z=-10.934; P<.001). The mean (SD) airway pressures were significantly different between the two groups (15.8 [1.9] and 14.9 [1.7] cm/HO for Baska and I-gel, respectively; t=3.668; P<.001). Seal pressure was not significantly different between the groups (0.08 [0.2] vs. 0.07 [0.2] cm/HO in the Baska and I-gel groups, respectively, (t=1.35; P=.194).

CONCLUSIONS

The Baska and I-gel masks are similar in most respects. Both have reasonably acceptable insertion times and can be used for selected surgical procedures.

LIMITATIONS

The requirement for more vigorous training is a limitation of the Baska mask. Results could differ with patients younger than 18 years of age or obese patients.

CONFLICT OF INTEREST

None.

CLINICAL TRIAL REGISTRY

Not registered.

摘要

背景

喉罩在手术期间维持气道方面越来越多地被用于替代气管插管或面罩。

目的

比较巴斯卡(Baska)喉罩和I-gel喉罩在接受泌尿外科手术的全身麻醉患者中的插入时间及其他特征。

设计

随机对照单盲研究。

地点

一家三级医院的泌尿外科手术室。

研究对象与方法

我们纳入预计手术持续时间少于两小时的同期患者。在给予术前用药并充分放松后,将受试者随机分配至I-gel喉罩组或巴斯卡喉罩组。使用计算机生成的随机数进行随机分组,并采用密封不透明信封进行分配隐藏。

主要观察指标

该研究的主要观察指标是喉罩气道(LMA)插入所需时间。此外,还包括器械放置尝试次数、术后体征和症状(咳嗽、屏气、喉痉挛、唇部损伤、面罩上有血迹)的数量,以及术后1小时和24小时的喉咽发病率评分。

样本量

211名符合纳入标准,200名参与者完成了研究。

结果

与I-gel喉罩相比,巴斯卡喉罩插入所需时间更长,气道压力更高。巴斯卡喉罩组和I-gel喉罩组LMA插入的中位(最小 - 最大)持续时间分别为14(6 - 25)秒和7(5 - 12)秒(z = -10.934;P <.001)。两组的平均(标准差)气道压力有显著差异(巴斯卡喉罩组和I-gel喉罩组分别为15.8 [1.9] 和14.9 [1.7] cm/HO;t = 3.668;P <.001)。两组间的密封压力无显著差异(巴斯卡喉罩组和I-gel喉罩组分别为0.08 [0.2] 与0.07 [0.2] cm/HO,(t = 1.35;P =.194)。

结论

巴斯卡喉罩和I-gel喉罩在大多数方面相似。两者的插入时间都较为可接受,可用于特定的外科手术。

局限性

巴斯卡喉罩需要更严格的培训是其局限性之一。18岁以下患者或肥胖患者的结果可能不同。

利益冲突

无。

临床试验注册

未注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a368/6832321/8faa55de6d27/asm-5-302.jpg

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