Department of Anesthesia, Surgical ICU and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
Anaesthesiol Intensive Ther. 2024;56(2):108-120. doi: 10.5114/ait.2024.141203.
The Air-Q Self Pressurized Airway Device with Blocker (SP Blocker) was compared to the Proseal Laryngeal Mask Airway (PLMA) during positive pressure ventilation regarding the primary outcome (oropharyngeal leak pressure [OLP]), secondary outcomes (peak inspiratory pressure [PIP], inspired tidal volume [ITV], expired tidal volume [ETV], leak volume [LV] and leak fraction [LF]), insertion time, ventilation score, fiber-optic glottis view score, and postoperative laryngopharyngeal parameters (LPM).
Adult healthy female patients scheduled for elective gynecological laparotomies under general anesthesia using controlled mechanical ventilation were recruited to a prospective randomized comparative clinical trial. Exclusion criteria were body mass index (BMI) ≥ 35 kg m -2 , El-Ganzouri score ≥ 5, upper airway problems, hiatus hernia or pregnancy. Patients were classified into an SP Blocker group ( n = 75) and a PLMA group ( n = 75). Primary and secondary outcomes were assessed initially and at fixed time points after successful insertion of devices.
Initially after successful device insertion: the SP Blocker group showed statistically significant higher mean OLP (cmH 2 O) (29.46 ± 2.11 vs. 28.06 ± 1.83 respectively; 95% CI: -2.037 to -0.76, P < 0.0001), lower mean PIP (cmH 2 O) (15.49 ± 0.61 vs. 17.78 ± 1.04 respectively; 95% CI: 2.02 to 2.56, P < 0.0001), higher mean ITV (mL) (411 ± 30 vs. 403 ± 15 respectively; 95% CI: -15.65 to -0.347, P = 0.041), higher mean ETV (mL) (389 ± 12 vs. 354 ± 11 respectively; 95% CI: -38.72 to -31.29, P < 0.0001), lower mean LV (mL) (22 ± 18 vs. 49 ± 10 respectively; 95% CI: 22.3 to 31.7, P < 0.0001) and lower mean LF (%) (5 ± 2.04 vs. 12 ± 6.8 respectively; 95% CI: 5.38 to 8.62, P < 0.0001) than the PLMA group. Mean insertion time (seconds) was shorter in the SP Blocker group than the PLMA group (16.39 ± 2.81 vs. 18.63 ± 3.44 respectively; 95% CI: 1.23 to 3.25, P < 0.0001). The SP Blocker group offered a better fiber-optic glottis view score than the PLMA group without differences concerning ventilation score and LPM.
SP Blocker provided as safe anesthesia during controlled mechanical ventilation as PLMA.
在正压通气过程中，Air-Q 自加压气道装置（SP 阻断器）与 Proseal 喉罩气道（PLMA）进行了比较，主要结果为（咽腔泄漏压[OLP]）、次要结果为（吸气峰压[PIP]、吸气潮气量[ITV]、呼气潮气量[ETV]、泄漏量[LV]和泄漏分数[LF]）、插入时间、通气评分、纤维光学声门视图评分和术后喉咽参数（LPM）。
选择计划在全身麻醉下接受妇科剖腹手术的成年健康女性患者进行前瞻性随机对照临床试验。排除标准为体重指数（BMI）≥35kg/m2、El-Ganzouri 评分≥5、上呼吸道问题、食管裂孔疝或妊娠。患者分为 SP 阻断器组（n=75）和 PLMA 组（n=75）。最初和成功插入设备后固定时间点评估主要和次要结果。
最初在成功插入设备后：SP 阻断器组的平均 OLP（cmH2O）（29.46±2.11 与 28.06±1.83 相比；95%CI：-2.037 至-0.76，P<0.0001）、平均 PIP（cmH2O）（15.49±0.61 与 17.78±1.04 相比；95%CI：2.02 至 2.56，P<0.0001）、平均 ITV（mL）（411±30 与 403±15 相比；95%CI：-15.65 至-0.347，P=0.041）、平均 ETV（mL）（389±12 与 354±11 相比；95%CI：-38.72 至-31.29，P<0.0001）、平均 LV（mL）（22±18 与 49±10 相比；95%CI：22.3 至 31.7，P<0.0001）和平均 LF（%）（5±2.04 与 12±6.8 相比；95%CI：5.38 至 8.62，P<0.0001）低于 PLMA 组。SP 阻断器组的平均插入时间（秒）短于 PLMA 组（16.39±2.81 与 18.63±3.44 相比；95%CI：1.23 至 3.25，P<0.0001）。SP 阻断器组提供的纤维光学声门视图评分优于 PLMA 组，而通气评分和 LPM 无差异。
SP 阻断器在控制机械通气期间提供了与 PLMA 一样安全的麻醉。
