Sood Suvidha, Chahar Shikha, Thakur Anil, Gupta Madhu, Saxena Anupriya, Subramanian Shalini
Department of Anesthesiology, ESI-PGIMSR, Basaidarapur, New Delhi, India.
Department of Anesthesiology, Narayana Nethralaya, Bengaluru, Karnataka, India.
J Anaesthesiol Clin Pharmacol. 2020 Oct-Dec;36(4):494-499. doi: 10.4103/joacp.JOACP_298_18. Epub 2021 Jan 18.
The objective of this prospective randomized blinded study was to assess the safety and efficacy of the laryngeal mask airway (LMA) Supreme as compared with the LMA Proseal.
A total of 60 patients were randomised into two groups to either receive a Proseal LMA (PLMA) or Supreme LMA (SLMA) for airway management. The primary outcome was to measure oropharyngeal leak pressure (OLP) in both groups. The secondary outcomes were the measurement of insertion time, insertion success rate, fibreoptic grading, intracuff pressure, ease of ventilation, and airway pressure on standard ventilatory settings and postoperative complications.
Intracuff pressure increase after 60 minutes of induction was significantly higher in the PLMA group (PLMA 97.43 ± 11.03 cm of HO and SLMA 75.17 ± 8.95 cm of HO). OLP was recorded after device insertion, after 30 min and after 60 min in each group and was found to be 28.71 ± 2.97, 30.93 ± 2.87, and 31.93 ± 2.72 cm of HO in PLMA and 24.84 ± 2.08, 26.73 ± 2.26, and 27.95 ± 2.55 cm of HO in SLMA group, respectively. The mean OLP with the SLMA was significantly (p=<.001) lower than PLMA. All the other parameters were comparable in both groups.
PLMA is better than SLMA as airway device to ventilate at higher airway pressure in paralyzed adult patients. On the basis of our study, we recommend Proseal over Supreme LMA.
这项前瞻性随机双盲研究的目的是评估喉罩气道(LMA)Supreme与LMA Proseal相比的安全性和有效性。
总共60例患者被随机分为两组,分别接受Proseal喉罩(PLMA)或Supreme喉罩(SLMA)进行气道管理。主要结局是测量两组的口咽漏气压(OLP)。次要结局包括插入时间、插入成功率、纤维支气管镜分级、套囊内压力、通气 ease、标准通气设置下的气道压力以及术后并发症。
诱导60分钟后,PLMA组的套囊内压力升高显著更高(PLMA为97.43±11.03 cmH₂O,SLMA为75.17±8.95 cmH₂O)。每组在装置插入后、30分钟后和60分钟后记录OLP,发现PLMA组分别为28.71±2.97、30.93±2.87和31.93±2.72 cmH₂O,SLMA组分别为24.84±2.08、26.73±2.26和27.95±2.55 cmH₂O。SLMA的平均OLP显著低于PLMA(p<0.001)。两组的所有其他参数相当。
对于麻痹的成年患者,在较高气道压力下进行通气时,PLMA作为气道装置优于SLMA。基于我们的研究,我们推荐Proseal而非Supreme LMA。