Thakur Deepali P, Malde Anila D
Department of Anaesthesiology, LTMMC and LTMG Hospital, Sion, Mumbai, Maharashtra, India.
Indian J Anaesth. 2020 Feb;64(2):125-130. doi: 10.4103/ija.IJA_635_19. Epub 2020 Feb 4.
Supraglottic airways (SGAs) should have good oropharyngeal seal pressures (OSP) for adequate ventilation and prevention of aspiration. Our aim was to study the effect of lateral position on OSP and thereby on ventilatory parameters for i-gel and ProSeal™ laryngeal mask airway (PLMA) in children.
In this prospective observational study, 86 children of ASA I-II, aged 1 month to 12 years, scheduled for elective surgery under general anaesthesia using i-gel or PLMA and requiring lateral position either for surgery or regional blocks were included. In both supine and lateral position OSP (constant flow method), expired tidal volume, fractional volume loss (%), and end-tidal carbon dioxide (ETCO) were noted. Intragroup and intergroup difference in OSP from supine to lateral position was analyzed using paired and unpaired -test respectively.
In lateral position, there was a significant decrease in the OSP (cm HO) in both i-gel (supine: 21.94 ± 5.82, lateral: 15.54 ± 5.37) and PLMA (supine: 17.53 ± 5.05, lateral: 12.76 ± 3.37) groups ( = 0.000). Percentage reduction in OSP from supine to lateral with i-gel (28.14 ± 18.86) and PLMA (24.06 ± 19.75) were comparable ( = 0.339). With both i-gel and PLMA significant increase in fractional volume loss and ETCO were noted in lateral position. I-gel group had higher OSP compared to PLMA in supine ( = 0.001) and lateral position ( = 0.009).
In lateral position there was significant reduction in OSP compared to supine position with both i-gel and PLMA.
声门上气道（SGA）应具备良好的口咽密封压（OSP），以实现充分通气并预防误吸。我们的目的是研究侧卧位对儿童使用i-gel喉罩和ProSeal™喉罩气道（PLMA）时的口咽密封压以及通气参数的影响。
在这项前瞻性观察研究中，纳入了86例年龄在1个月至12岁之间、ASA分级为I-II级、计划在全身麻醉下使用i-gel喉罩或PLMA进行择期手术且因手术或区域阻滞需要侧卧位的儿童。记录仰卧位和侧卧位时的口咽密封压（恒定流量法）、呼出潮气量、容积损失百分比（%）和呼气末二氧化碳（ETCO）。分别使用配对t检验和非配对t检验分析仰卧位到侧卧位时口咽密封压的组内和组间差异。
在侧卧位时，i-gel组（仰卧位：21.94±5.82，侧卧位：15.54±5.37）和PLMA组（仰卧位：17.53±5.05，侧卧位：12.76±3.37）的口咽密封压（cm H₂O）均显著降低（P = 0.000）。i-gel组（28.14±18.86）和PLMA组（24.06±19.75）从仰卧位到侧卧位时口咽密封压的降低百分比具有可比性（P = 0.339）。在侧卧位时，使用i-gel喉罩和PLMA均观察到容积损失百分比和呼气末二氧化碳显著增加。在仰卧位（P = 0.001）和侧卧位（P = 0.009）时，i-gel组的口咽密封压均高于PLMA组。
与仰卧位相比，使用i-gel喉罩和PLMA时，侧卧位的口咽密封压均显著降低。
