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麻醉儿童中Ambu AuraGain与i-gel的临床性能:一项前瞻性随机对照试验

Clinical performance of Ambu AuraGain versus i-gel in anesthetized children: a prospective, randomized controlled trial.

作者信息

Lee Ji-Hyun, Nam Seungpyo, Jang Young-Eun, Kim Eun-Hee, Kim Hee-Soo, Kim Jin-Tae

机构信息

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Anesth Pain Med (Seoul). 2020 Apr 30;15(2):173-180. doi: 10.17085/apm.2020.15.2.173. Epub 2020 Apr 29.

Abstract

BACKGROUND

Ambu AuraGain and i-gel have different characteristics in design each other. However, few reports evaluate which device has more benefits for ventilation in children undergoing paralyzed general anesthesia. This prospective, randomized controlled trial compared the clinical performance AuraGain and i-gel in anesthetized children.

METHODS

Children aged between 1 month and 7 years undergoing elective surgery were randomly assigned to the AuraGain and i-gel groups. The primary outcome was initial oropharyngeal leak pressure (OLP). Secondary outcomes were OLP at 10 min post-insertion, first-attempt and total insertion success rates, number of attempts and ease of gastric suction catheter placement, peak inspiratory pressure, fiberoptic bronchoscopic view score, ventilation quality, requirement of additional manipulation post-insertion, and complications.

RESULTS

Data of 93 patients were analyzed. The initial OLPs of the AuraGain and i-gel were 27.5 ± 7.7 and 25.0 ± 8.0 cmHO, respectively (P = 0.130). The OLP was significantly increased 10 min post-insertion in both groups. The initial success rates of the AuraGain and i-gel insertion were comparable. Suction catheter placement via the gastric port was easier (P = 0.018) and fiberoptic bronchoscopic view was better with the AuraGain (P < 0.001). The i-gel required additional manipulations post-insertion (P = 0.038). The incidence of complications during the emergence period was 10.8% for the i-gel and 2.2% for the AuraGain (P = 0.1).

CONCLUSIONS

OLP is comparable between AuraGain and i-gel. The AuraGain would be more favorable than the i-gel for use in pediatric patients under general anesthesia considering other outcomes.

摘要

背景

安普Ambu AuraGain喉罩和i-gel喉罩在设计上各有特点。然而,很少有报告评估哪种设备在接受麻痹性全身麻醉的儿童通气中更具优势。这项前瞻性随机对照试验比较了AuraGain喉罩和i-gel喉罩在麻醉儿童中的临床性能。

方法

将1个月至7岁接受择期手术的儿童随机分为AuraGain喉罩组和i-gel喉罩组。主要结局指标为初始口咽漏气压(OLP)。次要结局指标包括插入后10分钟时的OLP、首次尝试插入成功率和总插入成功率、尝试次数、胃吸引管放置的难易程度、吸气峰压、纤维支气管镜视野评分、通气质量、插入后额外操作的需求以及并发症。

结果

分析了93例患者的数据。AuraGain喉罩和i-gel喉罩的初始OLP分别为27.5±7.7cmH₂O和25.0±8.0cmH₂O(P = 0.130)。两组插入后10分钟时OLP均显著升高。AuraGain喉罩和i-gel喉罩的初始插入成功率相当。通过胃端口放置吸引管使用AuraGain喉罩更容易(P = 0.018),且使用AuraGain喉罩时纤维支气管镜视野更好(P < 0.001)。i-gel喉罩插入后需要额外操作(P = 0.038)。苏醒期i-gel喉罩组并发症发生率为10.8%,AuraGain喉罩组为2.2%(P = 0.1)。

结论

AuraGain喉罩和i-gel喉罩的OLP相当。考虑到其他结局指标,在全身麻醉的儿科患者中使用AuraGain喉罩比i-gel喉罩更具优势。

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