Aggarwal Manish, Yadav Rahul, Singh Shalendra, Bansal Deepali
Department of Anaesthesiology - Critical Care, Command Hospital (SC), Pune, India.
Department of Anaesthesiology - Critical Care, INHS Asvini, Colaba, Mumbai, India.
Turk J Anaesthesiol Reanim. 2021 Jun;49(3):244-249. doi: 10.5152/TJAR.2021.614.
Both the Supreme Laryngeal Mask Airway (SLMA) and the I-gel (I-gel) are supraglottic airway devices (SADs) commonly used for airway management in paediatric patients. This study aims to compare the efficacy in terms of insertion and ventilation profiles of size 2 SLMA and the I-gel in anaesthetised paediatric patients.
100 children were prospectively allocated to two groups depending upon the device inserted as SLMA (n = 50) and I-gel (n = 50). The primary outcomes were studied in terms of ease of insertion, haemodynamic changes, ventilation parameters, leak pressure and incidences of complications during general anaesthesia.
There were no failed attempts in the insertion of the airways in either group. The SLMA was more easily inserted in the majority of cases compared to the I-gel group. The number of attempts for insertion and the time taken for insertion were comparable in the I-gel and the SLMA group (13.8462.38 vs. 14.0261.7) (P .57, .66). Securing an effective airway took <30 seconds in both the groups with an overall median duration of 15 seconds. There was no difficulty in passing the gastric tube in either group (P<.30). There was a statistical difference between the oropharyngeal seal pressure (OSP), which was 25.1861.59 and 22.1061.36 cmH2O for SLMA and I-gel, respectively (P<.001). Haemodynamic parameters after the insertion of the device were comparable, and there were no clinically important complications in the post-operative period.
Both the devices appeared to be simple and suitable for airway management during elective surgery in paediatric patients. However, the SLMA was easily inserted with less insertion time in the majority of patients. Also, it provides higher OSP during anaesthesia and is better tolerated during emergence, with minimal risk of injury to the oropharynx.
喉上通气道(SLMA)和I-gel喉罩均为声门上气道装置(SADs),常用于小儿患者的气道管理。本研究旨在比较2号SLMA和I-gel喉罩在麻醉小儿患者中的插入及通气效果。
根据所插入的装置将100名儿童前瞻性地分为两组,SLMA组(n = 50)和I-gel喉罩组(n = 50)。主要观察指标包括插入的难易程度、血流动力学变化、通气参数、漏气压力以及全身麻醉期间的并发症发生率。
两组气道插入均无失败案例。与I-gel喉罩组相比,大多数情况下SLMA更容易插入。I-gel喉罩组和SLMA组的插入尝试次数及插入时间相当(13.84±6.238 对 14.02±6.17)(P = 0.57,0.66)。两组确保有效气道均用时<30秒,总体中位持续时间为15秒。两组插入胃管均无困难(P<0.30)。口咽密封压(OSP)存在统计学差异,SLMA和I-gel喉罩的口咽密封压分别为25.18±1.59和22.10±1.36 cmH2O(P<0.001)。装置插入后的血流动力学参数相当,术后无临床重要并发症。
两种装置似乎都简单且适用于小儿择期手术中的气道管理。然而,大多数患者中SLMA更容易插入,插入时间更短。此外,它在麻醉期间提供更高的口咽密封压,苏醒期耐受性更好,对口咽部的损伤风险最小。