Nevešćanin Ana, Vickov Josip, Elezović Baloević Sara, Pogorelić Zenon
Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital of Split, Split, Croatia.
School of Medicine, University of Split, Split, Croatia.
J Laparoendosc Adv Surg Tech A. 2020 Jan;30(1):76-80. doi: 10.1089/lap.2019.0382. Epub 2019 Oct 15.
The aim of this study was to compare the perioperative and postoperative respiratory complications between laryngeal mask (LM) airway and tracheal intubation (TI) in children undergoing percutaneous internal ring suturing (PIRS) for inguinal hernia. From October 2015 to February 2019, 135 pediatric patients (97 males and 38 females) with median age of 4 years, who underwent PIRS for inguinal hernia, were included in study. Patients were divided in two groups. In group I ( = 94) LM airway was used, and in group II ( = 41) TI was performed. Demographic data, surgical and anesthesia times, American Society of Anesthesiologists (ASA) classification, muscle relaxation, level of pneumoperitoneum, and complications of anesthesia were compared between the groups. No significant differences among compared groups regarding age ( = .435), sex ( = .306), body mass index ( = .548), ASA classification ( = .506), level of pneumoperitoneum ( = .968), and duration of surgery ( = .968) were found. Duration of anesthesia was significantly shorter when LM was used compared to TI (25 minutes versus 36 minutes; < .00001). During recovery from anesthesia, the incidences of desaturation ( = 1 versus = 5; = .003), laryngospasm ( = 2 versus = 5; = .015), and cough ( = 0 versus = 4; = .002) were significantly lower when LM airway was used for securing of the airway. Postoperative incidences of sore throat ( = .543), bronchospasm ( = .128), and aspiration ( = .128) did not differ between LM and TI. The use of LM in pediatric anesthesia results in a decrease in a number of common complications and significantly shortened patient anesthesia time. It is therefore a valuable device for the management of the pediatric airway for laparoscopic hernia repair in children.
本研究旨在比较在接受腹股沟疝经皮内环缝合术(PIRS)的儿童中,喉罩(LM)气道与气管插管(TI)在围手术期和术后的呼吸并发症。2015年10月至2019年2月,135例接受腹股沟疝PIRS的儿科患者(97例男性和38例女性)被纳入研究,中位年龄为4岁。患者分为两组。第一组(n = 94)使用喉罩气道,第二组(n = 41)进行气管插管。比较两组之间的人口统计学数据、手术和麻醉时间、美国麻醉医师协会(ASA)分级、肌肉松弛、气腹水平和麻醉并发症。在年龄(P = 0.435)、性别(P = 0.306)、体重指数(P = 0.548)、ASA分级(P = 0.506)、气腹水平(P = 0.968)和手术持续时间(P = 0.968)方面,比较组间未发现显著差异。与气管插管相比,使用喉罩时麻醉持续时间显著缩短(25分钟对36分钟;P < 0.00001)。在麻醉恢复期间,当使用喉罩气道确保气道安全时,血氧饱和度降低(P = 1对P = 5;P = 0.003)、喉痉挛(P = 2对P = 5;P = 0.015)和咳嗽(P = 0对P = 4;P = 0.002)的发生率显著降低。喉罩和气管插管术后喉咙痛(P = 0.543)、支气管痉挛(P = 0.128)和误吸(P = 0.128)的发生率无差异。在小儿麻醉中使用喉罩可减少一些常见并发症,并显著缩短患者麻醉时间。因此,它是小儿腹腔镜疝修补术中管理小儿气道的一种有价值的设备。