Hakim Mohammed, Bryant Jason, Miketic Renata, Williams Kent, Erdman Steven H, Shafy Shabana Z, Kim Stephani S, Tobias Joseph D
Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Department of Anesthesiology & Pain Medicine, The Ohio State University, Columbus, OH, USA.
Med Devices (Auckl). 2020 Sep 21;13:277-282. doi: 10.2147/MDER.S272557. eCollection 2020.
During esophagogastroduodenoscopy (EGD), general anesthesia (GA) may be provided using a laryngeal mask airway (LMA) with the endoscope inserted behind the cuff of the LMA into the esophagus. Passage of the endoscope may increase the intracuff of the LMA. We evaluated a newly designed LMA (LMA Gastro™ Airway) which has an internal channel exiting from its distal end to facilitate EGD. The current study compared the change of LMA cuff pressure between this new LMA and a standard clinical LMA (Ambu AuraOnce™) during EGD.
Patients less than 21 years of age and weighing more than 30 kg were randomized to receive airway management with one of the two LMAs during EGD. After anesthetic induction and successful LMA placement, the intracuff pressure of the LMAs was continuously monitored during the procedure. The primary outcome was the change of intracuff pressure of the LMAs.
The study cohort included 200 patients (mean age 13.6 years and weight 56.6 kg) who were randomized to the LMA Gastro™ Airway (n=100) or the Ambu AuraOnce™ LMA (n=100). Average intracuff pressures during the study period (before and after endoscope insertion) were not different between the two LMAs. Ease of the procedure was slightly improved with the LMA Gastro™ Airway (p<0.001).
The LMA Gastro™ Airway blunted, but did not prevent an increase in intracuff pressure during EGD when compared to the Ambu AuraOnce™ LMA. Throat soreness was generally low, and complications were infrequent in both groups. The ease of the procedure was slightly improved with the LMA Gastro™ Airway compared to the Ambu AuraOnce™ LMA.
在食管胃十二指肠镜检查（EGD）期间，可使用喉罩气道（LMA）实施全身麻醉（GA），将内窥镜插入LMA的套囊后方进入食管。内窥镜的通过可能会增加LMA的套内压力。我们评估了一种新设计的LMA（LMA Gastro™气道），其具有从远端引出的内部通道以方便进行EGD。本研究比较了在EGD期间这种新型LMA与标准临床LMA（Ambu AuraOnce™）之间LMA套囊压力的变化。
年龄小于21岁且体重超过30kg的患者在EGD期间被随机分配接受两种LMA之一进行气道管理。麻醉诱导和LMA成功置入后，在手术过程中持续监测LMA的套内压力。主要结局是LMA套内压力的变化。
研究队列包括200例患者（平均年龄13.6岁，体重56.6kg），他们被随机分配至LMA Gastro™气道组（n = 100）或Ambu AuraOnce™ LMA组（n = 100）。在研究期间（内窥镜插入前后），两种LMA的平均套内压力没有差异。使用LMA Gastro™气道时手术的便利性略有改善（p<0.001）。
与Ambu AuraOnce™ LMA相比，LMA Gastro™气道在EGD期间可减轻但不能防止套内压力升高。两组的咽痛一般较轻，并发症也很少见。与Ambu AuraOnce™ LMA相比，使用LMA Gastro™气道时手术的便利性略有改善。
