Department of Anesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey -
Department of Gastroenterology and Hepatology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
Minerva Anestesiol. 2021 Sep;87(9):987-996. doi: 10.23736/S0375-9393.21.15371-4. Epub 2021 May 13.
New generation airway devices with different designs have been developed as an alternative to endotracheal intubation in order to avoid adverse events associated with sedation in endoscopic procedures and to provide patent airway. We aimed to compare two supraglottic airway devices (SGADs), the LMA Gastro™ airway and gastrolaryngeal tube (GLT), in terms of airway efficiency, performance during procedure and adverse events in endoscopic retrograde cholangiopancreatography (ERCP).
A hundred-three ERCP patients without high risk of aspiration were included. Patients were randomly allocated to the LMA Gastro and GLT groups. The primary study outcomes were the comparison of the two SGADs in terms of oropharyngeal leak pressure (OLP). Secondary study outcome was SGADs-related adverse events.
Procedures were completed with SGADs in fifty patients in each group. The rate of successful insertion at first attempt was 72% in GLT and 96% in LMA Gastro (P=0.004). The mean OLP of LMA Gastro Group (31.8 cmH
LMA Gastro™ had a higher OLP than GLT. However, GLT was better for endoscopist satisfaction, as it provides more satisfying maneuverability. As to secondary outcome advers events were lower in LMA Gastro™. The lower complication rates associated with the device and providing a more patent airway also highlighted the apparent clinical efficacy of LMA Gastro™ than GLT, in ERCP.
为了避免内镜检查中镇静相关的不良事件并保持气道通畅，已经开发出了具有不同设计的新一代气道设备，以替代气管插管。我们旨在比较两种声门上气道装置（SGAD），即 LMA Gastro™气道和胃喉管（GLT），在经内镜逆行胰胆管造影术（ERCP）中的气道效率、操作过程中的表现和不良事件方面的差异。
纳入 103 例无吸入高危风险的 ERCP 患者。患者随机分配到 LMA Gastro 和 GLT 组。主要研究结局是比较两种 SGAD 在声门上漏压（OLP）方面的差异。次要研究结局是与 SGAD 相关的不良事件。
在每组 50 例患者中，均成功使用 SGAD 完成了操作。GLT 组首次尝试插入的成功率为 72%，而 LMA Gastro 组为 96%（P=0.004）。LMA Gastro 组的平均 OLP（31.8cmH
LMA Gastro™的 OLP 高于 GLT。然而，GLT 更能满足内镜医师的需求，因为它提供了更满意的可操作性。在次要结果中，LMA Gastro™的不良事件发生率较低。该设备相关并发症发生率较低，且能提供更通畅的气道，这也突出了 LMA Gastro™在 ERCP 中明显优于 GLT 的临床疗效。
