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一项前瞻性单中心观察性研究,旨在评估第二代声门上气道装置I-gel在儿童腹腔镜手术中的疗效。

A prospective single-center observational study to assess the efficacy of the second-generation supraglottic airway device I-gel in laparoscopic surgeries in children.

作者信息

Goyal Rakhee, Chauhan Rajat, Anand Rajan, Goyal Manoj

机构信息

Department of Anesthesia and Critical Care, Army Hospital Research and Referral, New Delhi, India.

Department of Anesthesia and Critical Care, Madhukar Rainbow Children's Hospital, New Delhi, India.

出版信息

J Anaesthesiol Clin Pharmacol. 2020 Jan-Mar;36(1):20-24. doi: 10.4103/joacp.JOACP_295_19. Epub 2020 Feb 18.

Abstract

BACKGROUND AND AIMS

Supraglottic airways used in pediatric surgeries are associated with a lesser number of postanesthesia respiratory complications. However, there is limited literature on the use of i-gel for pediatric laparoscopic surgery. The aim of this study is to assess the adequacy of ventilation of i-gel for pediatric laparoscopic surgery and note any associated adverse event.

MATERIAL AND METHODS

This is a single-centered prospective observational study including 119 children, aged 6 months to 18 years, scheduled for laparoscopic surgery, during a 9-month period, in a tertiary care center. I-gel was used for positive pressure ventilation, and if the post-insertion oropharyngeal seal pressure was <25 cm HO, it was replaced with a tracheal tube. Adequacy of ventilation and adverse events were noted.

RESULTS

Data from 102 cases were analyzed (17 cases excluded: tracheal intubation in 11; missing data in 6 cases). The mean oropharyngeal seal pressure was 34.2 ± 5.2 cm HO and mean airway pressure was 16.1 ± 2.4 cm HO. The adverse events included transient cough (10.7%), sore throat (4.9%), and desaturation (3.9%). There was no sign of respiratory distress during the recovery and no intervention was required in any child postoperatively.

CONCLUSION

I-gel provided adequate ventilation of the lungs in children undergoing laparoscopic surgery with no major adverse event.

摘要

背景与目的

儿科手术中使用的声门上气道与较少的麻醉后呼吸并发症相关。然而,关于i-gel在小儿腹腔镜手术中的应用的文献有限。本研究的目的是评估i-gel在小儿腹腔镜手术中的通气充分性,并记录任何相关不良事件。

材料与方法

这是一项单中心前瞻性观察性研究,纳入了一家三级医疗中心在9个月期间计划进行腹腔镜手术的119名6个月至18岁的儿童。使用i-gel进行正压通气,如果插入后口咽密封压<25 cm H₂O,则更换为气管导管。记录通气充分性和不良事件。

结果

分析了102例病例的数据(排除17例:11例气管插管;6例数据缺失)。平均口咽密封压为34.2±5.2 cm H₂O,平均气道压为16.1±2.4 cm H₂O。不良事件包括短暂咳嗽(10.7%)、咽痛(4.9%)和血氧饱和度下降(3.9%)。恢复期间无呼吸窘迫迹象,术后任何儿童均无需干预。

结论

i-gel为接受腹腔镜手术的儿童提供了充分的肺通气,且无重大不良事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a51e/7047697/b44cf185c27b/JOACP-36-20-g001.jpg

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