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喉罩在扁桃体切除术和腺样体切除术的应用。

The use of laryngeal mask airway for tonsillectomy and adenoidectomy.

机构信息

Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA.

Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA; Department of Anesthesiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA.

出版信息

Int J Pediatr Otorhinolaryngol. 2021 May;144:110691. doi: 10.1016/j.ijporl.2021.110691. Epub 2021 Mar 20.

Abstract

PURPOSE

Patients undergoing tonsillectomy and adenoidectomy traditionally receive anesthesia with endotracheal intubation (ETT) for airway management. The laryngeal mask airway (LMA) may be used instead and may be associated with less airway stimulation and shorter operating room times. The purpose of this study was to report on a large cohort of patients undergoing tonsillectomy and/or adenoidectomy while using the LMA for airway maintenance during anesthesia.

METHODS

Patients undergoing tonsillectomy and adenoidectomy between January 6, 2017 and January 6, 2020 with a LMA were reviewed for safety outcomes. We compared two cohorts of patients with LMA and ETT to analyze the effect on operating room times.

RESULTS

Our study identified 1042 patients who met criteria for review. The incidence of cases requiring conversion to ETT (1.2%) and laryngospasm (0.3%) in our cohort is lower than previously suggested by the literature. The patients who underwent surgery with the LMA spent less time in the operating room (p = 0.004) compared to the ETT group.

CONCLUSION

The use of the LMA may be a safe and effective option for airway management during tonsillectomy and adenoidectomy. There may be a benefit of OR time reduction in patients undergoing anesthesia with an LMA compared to ETT.

摘要

目的

传统上,接受扁桃体切除术和腺样体切除术的患者需要通过气管内插管(ETT)进行麻醉以管理气道。喉罩气道(LMA)也可以代替 ETT 使用,它可能与较少的气道刺激和较短的手术室时间有关。本研究的目的是报告在接受麻醉时使用 LMA 维持气道的情况下,进行扁桃体切除术和/或腺样体切除术的大量患者的情况。

方法

对 2017 年 1 月 6 日至 2020 年 1 月 6 日期间接受扁桃体切除术和腺样体切除术且使用 LMA 的患者进行安全性结果回顾。我们比较了 LMA 和 ETT 两组患者对手术室时间的影响。

结果

我们的研究确定了 1042 名符合审查标准的患者。在我们的队列中,需要转换为 ETT(1.2%)和发生喉痉挛(0.3%)的病例发生率低于文献先前提出的发生率。与 ETT 组相比,接受 LMA 手术的患者在手术室的时间更短(p=0.004)。

结论

在扁桃体切除术和腺样体切除术中,使用 LMA 可能是一种安全有效的气道管理选择。与 ETT 相比,接受 LMA 麻醉的患者可能会受益于手术室时间的缩短。

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