Leister Nicolas, Heindl Ludwig M, Rokohl Alexander C, Böttiger Bernd W, Menzel Christoph, Ulrichs Christoph, Schick Volker C
Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Kerpener Street 62, 50937 Cologne, Germany.
Department of Ophthalmology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Kerpener Street 62, 50937 Cologne, Germany.
Children (Basel). 2024 Mar 7;11(3):320. doi: 10.3390/children11030320.
The use of laryngeal masks in the surgical treatment of infantile lacrimal duct stenosis is controversial due to the potential risk of aspiration. This study investigates airway procedures in children aged <6 years for surgery of lacrimal duct stenosis in a tertiary care university hospital. After institutional approval, airway procedures, duration of anesthesiological measures, and airway-related complications were retrospectively analyzed. Patients were divided into two groups according to the airway procedures used (endotracheal tube [ET] vs. laryngeal mask [LMA] airway). Associations were calculated using the Chi-square test or Mann-Whitney U-test. Clinical data of 84 patients (ET = 36 [42.9%] vs. LMA = 48 [57.1%]) were analyzed. There were no significant differences in surgical treatment, age distribution, and pre-existing conditions between the groups. None of the patients showed evidence of tracheal aspiration or changes in measured oxygen saturation. LMA airway shortened time for anesthesia induction ( = 0.006) and time for recovery/emergence period ( = 0.03). In contrast, the time to discharge from the recovery room was significantly prolonged using LMA ( = 0.001). A total of 7 adverse events were recorded. Five of these were directly or indirectly related to ET (laryngo-/bronchospasm; muscle relaxant residual). LMA airway for infantile lacrimal duct stenosis seems to be a safe procedure and should be used in appropriate pediatric patients due to its lower invasiveness, low complication rate, and time savings.
由于存在误吸的潜在风险，喉罩在小儿泪道狭窄手术治疗中的应用存在争议。本研究在一家三级护理大学医院中，调查了年龄小于6岁的儿童在泪道狭窄手术中的气道处理方法。经机构批准后，对气道处理方法、麻醉措施持续时间及气道相关并发症进行了回顾性分析。根据所采用的气道处理方法（气管插管[ET]与喉罩[LMA]气道）将患者分为两组。使用卡方检验或曼-惠特尼U检验计算相关性。分析了84例患者的临床资料（ET组 = 36例[42.9%]，LMA组 = 48例[57.1%]）。两组在手术治疗、年龄分布及既往病史方面无显著差异。所有患者均未出现气管误吸或测量的血氧饱和度变化的证据。LMA气道缩短了麻醉诱导时间（P = 0.006）和苏醒/恢复期时间（P = 0.03）。相比之下，使用LMA时从恢复室出院的时间显著延长（P = 0.001）。共记录了7例不良事件。其中5例与ET直接或间接相关（喉/支气管痉挛；肌肉松弛剂残留）。对于小儿泪道狭窄，LMA气道似乎是一种安全的方法，由于其侵入性较低、并发症发生率低且节省时间，应在合适的儿科患者中使用。
