Kannojiya Durga P, Gautam Shefali, Srivastava Vinod K, Singh Gyan Prakash, Maurya Ram G, Malik Anita, Agarwal Jyotsna, Kohli Monica
Department of Anaesthesiology and Critical Care, King George's Medical University, Lucknow, IND.
Cureus. 2021 Jul 31;13(7):e16798. doi: 10.7759/cureus.16798. eCollection 2021 Jul.
Laryngeal mask airways (LMAs) are widely used in paediatric anaesthesia. However, LMA use in neonatal age groups (younger than seven days) is limited because many anaesthesiologists prefer to use endotracheal tube in neonates. In this study, we compared the ProSeal LMA and endotracheal tube by measuring their performance, including ease of insertion via number of attempts for placement of device, total effective time for intubation and extubation, hemodynamic responses and perioperative complications.
In this prospective randomized study, 70 patients (neonates) weighing >2.5 kg, with American Society of Anaesthesiologists (ASA) classification grade 4 requiring emergency surgery for anorectal malformation were enrolled and divided into two groups. After induction, patients' airways were secured with either ProSeal LMA size 1 (Group I) or endotracheal tube (Group II). Anaesthesia was maintained on oxygen and sevoflurane with muscle relaxant atracurium.
Demographic and surgical data were similar between the two groups. The ProSeal LMA insertion time was shorter than endotracheal intubation. Hemodynamic variations were less in the ProSeal LMA group as compared to the endotracheal tube group. The total time for removal of airway devices from the end of surgery for the ProSeal group was lower than that for the endotracheal intubation group. Postoperative complications were less in the ProSeal group as compared to the endotracheal group.
The ProSeal LMA can be a better alternative to the endotracheal tube in neonates due to the ease of insertion, lesser changes in hemodynamic parameters and minimal postoperative complications.
喉罩气道（LMA）在小儿麻醉中广泛应用。然而，LMA在新生儿年龄组（小于7天）中的使用受限，因为许多麻醉医生更倾向于在新生儿中使用气管内导管。在本研究中，我们通过测量其性能，包括通过放置设备的尝试次数来评估插入的难易程度、插管和拔管的总有效时间、血流动力学反应和围手术期并发症，对ProSeal喉罩和气管内导管进行了比较。
在这项前瞻性随机研究中，纳入了70例体重>2.5 kg、美国麻醉医师协会（ASA）分级为4级、因肛门直肠畸形需要急诊手术的新生儿患者，并将其分为两组。诱导后，用1号ProSeal喉罩（I组）或气管内导管（II组）确保患者气道安全。使用氧气和七氟醚并加用肌肉松弛剂阿曲库铵维持麻醉。
两组的人口统计学和手术数据相似。ProSeal喉罩的插入时间比气管内插管短。与气管内导管组相比，ProSeal喉罩组的血流动力学变化较小。ProSeal组从手术结束到移除气道设备的总时间低于气管内插管组。与气管内导管组相比，ProSeal组的术后并发症较少。
由于插入容易、血流动力学参数变化较小且术后并发症极少，ProSeal喉罩可能是新生儿气管内导管的更好替代品。
