Turk Hacer Sebnem, Sayin Pinar, Kilinc Leyla, Akin Melih, Yildiz Abdullah, Oba Sibel
Department of Anesthesiology and Reanimation, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Research Hospital, Istanbul, Turkey.
Department of Pediatric Surgery, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Research Hospital, Istanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2021 Mar 17;55(1):108-114. doi: 10.14744/SEMB.2020.98623. eCollection 2021.
We aimed to investigate the effects of intubation and laryngeal mask airway (LMA) use by evaluating the results of blood gas tests, end-tidal CO measurements, and airway changes during laparoscopic inguinal hernia repair in children.
This study was designed to be a prospective randomized study enrolling 150 ASA-I patients, aged 1-8 years; who were scheduled for laparoscopic inguinal hernia repair. Group 1 (n=75) received general anesthesia with fentanyl, propofol, and rocuronium and they were orotracheally intubated. Group 2 (n=75) received general anesthesia with fentanyl and propofol and were inserted an LMA. Demographical data were recorded. Arterial blood gas test results at baseline, in the 10 min after the insufflation, and in the 10 min after the end of the insufflation were noted. The end-tidal CO, HR, SPO, inspiratory pressure, plateau pressure, tidal volume (TV), and respiratory frequencies were recorded. The duration of anesthesia, operation, and insufflations was noted. Emergent complications were recorded.
The duration of both anesthesia and recovery was longer in Group 1 compared to Group 2. Hemodynamical parameters, end-tidal CO values, TVs, airway pressures, and respiratory frequencies were not statistically significantly different between the groups. There were no statistically meaningful differences in the levels of pH, PCO, and PO between the groups.
Compared to orotracheal intubation during laparoscopic inguinal surgery; LMA did not cause any statistically significant differences in the blood gas test results or airway pressures and recovery was faster with LMA. Therefore, LMA can be used in pediatric laparoscopic surgery as a safe tool for maintaining the airway.
我们旨在通过评估小儿腹腔镜腹股沟疝修补术中血气分析结果、呼气末二氧化碳监测结果及气道变化，来研究气管插管和喉罩气道（LMA）使用的效果。
本研究设计为前瞻性随机研究，纳入150例年龄在1至8岁的ASA-I级患者，这些患者计划接受腹腔镜腹股沟疝修补术。第1组（n = 75）接受芬太尼、丙泊酚和罗库溴铵全身麻醉，并经口气管插管。第2组（n = 75）接受芬太尼和丙泊酚全身麻醉，并插入喉罩。记录人口统计学数据。记录基线、气腹后10分钟和气腹结束后10分钟的动脉血气分析结果。记录呼气末二氧化碳、心率、血氧饱和度、吸气压力、平台压、潮气量（TV）和呼吸频率。记录麻醉、手术和气腹持续时间。记录术中并发症。
与第2组相比，第1组的麻醉和恢复时间更长。两组间血流动力学参数、呼气末二氧化碳值、潮气量、气道压力和呼吸频率无统计学显著差异。两组间pH值、二氧化碳分压和氧分压水平无统计学意义上的差异。
与腹腔镜腹股沟手术中气管插管相比，喉罩在血气分析结果或气道压力方面未引起任何统计学显著差异，且使用喉罩恢复更快。因此，喉罩可作为小儿腹腔镜手术中维持气道的安全工具。
