LMA Gastro™ 气道在高危患者的上消化道介入性内镜检查中是可行的：一项单中心观察性研究。
LMA Gastro™ airway is feasible during upper gastrointestinal interventional endoscopic procedures in high risk patients: a single-center observational study.
机构信息
Department of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg im Breisgau, Germany.
Department of Medicine II, Faculty of Medicine, Medical Center - University of Freiburg University of Freiburg, Hugstetter Strasse 55, Freiburg im Breisgau, 79106, Germany.
出版信息
BMC Anesthesiol. 2020 Feb 8;20(1):40. doi: 10.1186/s12871-020-0938-9.
BACKGROUND
Nonoperating room anesthesia during gastroenterological procedures is a growing field in anesthetic practice. While the numbers of patients with severe comorbidities are rising constantly, gastrointestinal endoscopic interventions are moving closer to minimally invasive endoscopic surgery. The LMA Gastro™ is a new supraglottic airway device, developed specifically for upper gastrointestinal endoscopy and interventions. The aim of this study was to evaluate the feasibility of LMA Gastro™ in patients with ASA physical status ≥3 undergoing advanced endoscopic procedures.
METHODS
We analyzed data from 214 patients retrospectively who received anesthesia for gastroenterological interventions. Inclusion criteria were upper gastrointestinal endoscopic interventions, airway management with LMA Gastro™ and ASA status ≥3. The primary outcome measure was successful use of LMA Gastro™ for airway management and endoscopic intervention.
RESULTS
Thirtyone patients with ASA physical status ≥3, undergoing complex and prolonged upper gastrointestinal endoscopic procedures were included. There were 7 endoscopic retrograde cholangiopancreatographies, 7 peroral endoscopic myotomies, 5 percutaneous endoscopic gastrostomies and 12 other complex procedures (e.g. endoscopic submucosal dissection, esophageal stent placement etc.). Of these, 27 patients were managed successfully using the LMA Gastro™. Placement of the LMA Gastro™ was reported as easy. Positive pressure ventilation was performed without difficulty. The feasibility of the LMA Gastro™ for endoscopic intervention was rated excellent by the endoscopists. In four patients, placement or ventilation with LMA Gastro™ was not possible.
CONCLUSIONS
We demonstrated the feasibility of the LMA Gastro™ during general anesthesia for advanced endoscopic procedures in high-risk patients.
TRIAL REGISTRATION
German Clinical Trials Register (DRKS00017396) Date of registration: 23rd May 2019, retrospectively registered.
背景
胃肠内窥镜检查期间的非手术室麻醉是麻醉实践中的一个新兴领域。虽然患有严重合并症的患者数量不断增加，但胃肠内窥镜介入治疗越来越接近微创内窥镜手术。LMA Gastro™ 是一种新型的声门上气道装置，专为上消化道内窥镜检查和介入治疗而开发。本研究旨在评估 LMA Gastro™ 在接受高级内窥镜检查的 ASA 身体状况≥3 级的患者中的可行性。
方法
我们回顾性分析了 214 例接受胃肠介入麻醉的患者的数据。纳入标准为上消化道内窥镜介入治疗、使用 LMA Gastro™ 进行气道管理和 ASA 状态≥3。主要观察指标是 LMA Gastro™ 用于气道管理和内窥镜介入的成功率。
结果
31 例 ASA 身体状况≥3 级、接受复杂和长时间上消化道内窥镜检查的患者被纳入研究。其中有 7 例经内镜逆行胰胆管造影术、7 例经口内镜肌切开术、5 例经皮内镜胃造口术和 12 例其他复杂手术（如内镜黏膜下剥离术、食管支架置入术等）。其中 27 例患者成功地使用了 LMA Gastro™。LMA Gastro™ 的放置被报告为容易。正压通气无困难进行。内镜医生对 LMA Gastro™ 进行内镜介入的可行性评价为优秀。在 4 例患者中，无法放置或通气 LMA Gastro™。
结论
我们证明了 LMA Gastro™ 在高危患者接受高级内窥镜检查时全身麻醉中的可行性。
试验注册
德国临床试验注册处（DRKS00017396）注册日期：2019 年 5 月 23 日，回顾性注册。
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