Mishra Rajesh, Kaur Ranvinder, Suri Aditi, Yadav Rupesh, Wasnik Seema
Department of Anaesthesia, ABVIMS and Dr. RML Hospital, New Delhi, India.
Department of Critical Care Medicine, ABVIMS and Dr. RML Hospital, New Delhi, India.
J Anaesthesiol Clin Pharmacol. 2024 Jan-Mar;40(1):63-68. doi: 10.4103/joacp.joacp_217_22. Epub 2024 Mar 14.
Several methods are in use for LMA ProSeal™ size selection in pediatric patients. Weight-based method is most commonly used. Pinna size-based method is a promising new technique for accurate size selection.
A total of 146 children aged between 6 months and 12 years undergoing surgery under general surgery were included. They were randomized into either pinna-based group (group X) or weight-based group (group Y). Both groups were compared for accurate placement of ProSeal™ laryngeal mask airway (PLMA), ease of insertion, number of attempts needed, and peak airway pressures.
A Comparable number of patients had a Brimacombe score of 3 and above, indicating correct placement in both groups ( = 0.407). PLMA was easily inserted in 79.5% and 87.7% of patients of groups X and Y, respectively ( = 0.180). Insertion was found to be difficult in 20.5% of patients in group X, whereas it was difficult in only 12.3% of patients of group Y ( = 0.180). The two groups were comparable as per the number of attempts needed for insertion ( = 0.161). Mean peak airway pressures too were comparable between both groups. Ease of insertion too, was statistically insignificant between both groups.
Pinna size-based estimation of LMA size is an effective alternative method to weight-based selection.
儿科患者中,有多种方法可用于选择喉罩通气道(LMA ProSeal™)的尺寸。基于体重的方法最为常用。基于耳廓大小的方法是一种有望实现准确尺寸选择的新技术。
纳入146例年龄在6个月至12岁之间接受普外科手术的儿童。他们被随机分为基于耳廓大小的组(X组)或基于体重的组(Y组)。比较两组在喉罩通气道(PLMA)的准确放置、插入的难易程度、所需尝试次数以及气道峰值压力。
两组中Brimacombe评分达到3分及以上的患者数量相当,表明两组放置均正确(P = 0.407)。X组和Y组分别有79.5%和87.7%的患者PLMA易于插入(P = 0.180)。X组有20.5%的患者插入困难,而Y组仅12.3% 的患者插入困难(P = 0.180)。两组插入所需尝试次数相当(P = 0.161)。两组的平均气道峰值压力也相当。两组之间插入的难易程度在统计学上也无显著差异。
基于耳廓大小估计喉罩尺寸是基于体重选择的一种有效替代方法。