比较 BlockBuster 喉罩与 Air-Q 插管型喉道作为儿童纤维光导插管导丝的通道：一项前瞻性随机对照研究。
Comparison of BlockBuster laryngeal mask with Air-Q intubating laryngeal airway as a conduit for fiber-optic guided intubation in children: A prospective randomized controlled study.
机构信息
Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
出版信息
Paediatr Anaesth. 2024 Jul;34(7):671-677. doi: 10.1111/pan.14906. Epub 2024 Apr 22.
BACKGROUND
The pediatric sizes of BlockBuster supraglottic airway (SGA) have been introduced recently. Its efficacy as a conduit for endotracheal intubation in children has not been assessed. Newer devices are often compared with Air-Q SGA to assess their intubating capability.
AIMS
The primary objective was to compare the time taken for fiber-optic-guided intubation through the BlockBuster and the Air-Q SGAs.
METHODS
Sixty children aged 6 months to 12 years with normal airways were randomized into two groups: Air-Q SGA (Group A) and Blockbuster SGA (Group B). After administration of general anesthesia, an appropriately sized SGA was inserted. The time taken for fiber-optic-guided intubation through the SGA, success, ease, and time for SGA insertion and removal were noted. The glottic view was graded by fiber-optic bronchoscopy.
RESULTS
Demographic parameters were comparable. The time to intubate with the BlockBuster 62.40 ± 17.2 s was comparable to the Air-Q 60.8 ± 18.5 s (mean difference 1.6 s, 95% CI -7.65 to10.85; p = .73). The average time for SGA insertion in BlockBuster and Air-Q was 14.57 ± 3.2 s and 16.67 ± 5.39 s, respectively (mean difference -2.1, 95% CI -4.39 to 0.19 s; p = .07). The first-attempt intubation success and overall intubation success rates were comparable in both groups, 96.7% and 100%, respectively. In Group B, 25/3/1/1/0 cases had a glottic view grade of 1/2/3/4/5, respectively. In Group A, 23/3/2/2/0 cases had grade of 1/2/3/4/5 glottic views respectively. The average time to SGA removal was comparable between the BlockBuster (20.17 ± 5.8 s) and the Air-Q (22.5 ± 12.8 s) groups (mean difference -2.3 s, 95% CI -7.5 to 2.82 s; p = .37). None of the children had any perioperative complications.
CONCLUSION
BlockBuster SGA may be a useful alternative to Air-Q for SGA-assisted, fiber-optic-guided tracheal intubation in children.
背景
最近推出了儿童用 BlockBuster 声门上气道（SGA）的儿科尺寸。尚未评估其作为儿童气管内插管导管的效果。通常会将较新的设备与 Air-Q SGA 进行比较，以评估其插管能力。
目的
主要目的是比较纤维光学引导通过 BlockBuster 和 Air-Q SGA 的插管时间。
方法
将 60 名年龄在 6 个月至 12 岁之间、气道正常的儿童随机分为两组：Air-Q SGA（A 组）和 Blockbuster SGA（B 组）。给予全身麻醉后，插入适当尺寸的 SGA。记录通过 SGA 进行纤维光学引导插管的时间、成功率、容易程度以及 SGA 插入和取出的时间。通过纤维光学支气管镜对声门视图进行分级。
结果
人口统计学参数无差异。BlockBuster 62.40±17.2s 的插管时间与 Air-Q 60.8±18.5s 相当（平均差异 1.6s，95%CI-7.65 至 10.85；p=0.73）。BlockBuster 和 Air-Q 的 SGA 插入平均时间分别为 14.57±3.2s 和 16.67±5.39s（平均差异-2.1，95%CI-4.39 至 0.19s；p=0.07）。两组的首次尝试插管成功率和总体插管成功率均相当，分别为 96.7%和 100%。B 组 25/3/1/1/0 例的声门视图分级分别为 1/2/3/4/5，A 组分别为 23/3/2/2/0。SGA 取出的平均时间在 BlockBuster（20.17±5.8s）和 Air-Q（22.5±12.8s）组之间无差异（平均差异-2.3s，95%CI-7.5 至 2.82s；p=0.37）。无患儿发生围手术期并发症。
结论
BlockBuster SGA 可能是替代 Air-Q 用于儿童 SGA 辅助纤维光学引导气管插管的有用选择。
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