Atar Funda, Keskin Gülsen, Karaca Akaslan Filiz, Tıraş Yasemin, Dönmez Aslı
Department of Anaesthesiology and Reanimation, Etlik City Hospital, University of Health Sciences Turkey, Ankara, Turkey.
Turk J Anaesthesiol Reanim. 2023 Oct 24;51(5):395-401. doi: 10.4274/TJAR.2023.231225.
This prospective randomized study compared 2 different methods for Proseal Laryngeal Mask Airway (PLMA) fixation.
Patients scheduled for ureterorenoscopic lithotripsy surgery in the lithotomy position were included in the study. General anaesthesia with PLMA was administered to the patients. To achieve PLMA fixation, patients were randomly assigned to either adjustable elastic band (Group I) or adhesive tape fixation (Group II). Fiberoptic bronchoscope (FOB) evaluation and glottic image grading (grade 1-4) and lip margin distances of PLMA (M1 and M2) were evaluated before and after the surgical procedure.
We enrolled 116 patients. Surgery of 7 patients was postponed. PLMA dislocated in 2 patients in group II during positioning. For another patient who used adhesive tape in Group II, it was removed because it could not adhere to properly, and a new sticking plaster was used. The study was completed with 106 patients. In FOB evaluation, the number of patients with optimal FOB grade (FOB grade 1) after PLMA was inserted and fixed was more in Group I than in Group II ( = 0.01). FOB evaluation was repeated at the end of the operation, and the number of patients with the worst FOB grade (FOB grade 4) was 0 (0%) and 11 (10.5%) in Groups I and II, respectively. PLMA displaced more than 1 cm in 10 (18.9%) patients in Group I and in 30 patients (56.6%) in Group II.
The adjustable elastic band method is simple, easy, and convenient and can be used in any surgical procedure for PLMA fixation.
本前瞻性随机研究比较了两种不同的喉罩气道(PLMA)固定方法。
纳入计划在截石位进行输尿管镜碎石手术的患者。患者接受PLMA全身麻醉。为实现PLMA固定,患者被随机分配至可调弹性带组(I组)或胶带固定组(II组)。在手术前后评估纤维支气管镜(FOB)、声门图像分级(1-4级)及PLMA的唇缘距离(M1和M2)。
我们纳入了116例患者。7例患者的手术被推迟。II组有2例患者在体位摆放时PLMA脱位。II组另1例使用胶带的患者,因胶带粘贴不牢被移除,更换了新的胶布。106例患者完成了研究。在FOB评估中,PLMA插入并固定后FOB分级最佳(FOB 1级)的患者数量I组多于II组(=0.01)。手术结束时重复FOB评估,I组和II组中FOB分级最差(FOB 4级)的患者数量分别为0例(0%)和11例(10.5%)。I组有10例(18.9%)患者PLMA移位超过1 cm,II组有30例(56.6%)患者PLMA移位超过1 cm。
可调弹性带法简单、易行、方便,可用于任何PLMA固定的手术。