Wang Wanling, Sun Yanbin, Zhao Zhenru, Guan Jiao
Department of Anesthesiology, Chengde Central Hospital, Chengde, Hebei, P.R. China.
Medicine (Baltimore). 2025 Mar 14;104(11):e41718. doi: 10.1097/MD.0000000000041718.
This study evaluates the clinical efficacy of combining a laryngeal mask airway with a bronchial blocker (LMA-BB) in single-lung ventilation (OLV) during thoracic surgery compared to the traditional single-lumen tracheal tube with a bronchial blocker (single-lumen tracheal tube [SLT] + BB). A retrospective analysis was performed on 93 patients undergoing thoracic surgery with OLV from December 2021 to September 2023. After propensity score matching (1:1), 34 patients remained in each group (LMA-BB and SLT + BB). Key outcomes, including airway pressures, ventilation and oxygenation parameters, lung compliance, postoperative recovery, and complications, were compared between groups. After matching, the 2 groups had similar baseline characteristics. The LMA-BB group showed significant advantages in airway pressure management, with lower peak and plateau pressures (P < .05). Ventilation and oxygenation efficiency were superior in the LMA-BB group, including lower end-tidal carbon dioxide (37.8 ± 4.7 vs 39.2 ± 5.1 mm Hg, P = .04) and higher oxygenation index (255 ± 22 vs 245 ± 28, P = .04). Lung compliance was improved (P = .018), and more patients in the LMA-BB group achieved excellent lung collapse (76.5% vs 52.9%, P = .032). Additionally, postoperative recovery was faster, with shorter extubation times (12.4 ± 3.2 vs 14.8 ± 3.6 minutes, P = .003) and fewer complications, including hypoxemia (5.9% vs 23.5%, P = .027) and pulmonary issues (8.8% vs 20.6%, P = .046). The LMA-BB technique offers significant clinical benefits over the traditional SLT + BB method in thoracic OLV, including improved airway management, ventilation efficiency, lung compliance, and faster recovery. It also reduces postoperative complications, making it a promising alternative for thoracic surgery.
本研究评估了在胸外科手术单肺通气(OLV)中,喉罩气道联合支气管阻塞器(LMA-BB)相较于传统单腔气管导管联合支气管阻塞器(单腔气管导管[SLT]+BB)的临床疗效。对2021年12月至2023年9月期间接受OLV胸外科手术的93例患者进行回顾性分析。经过倾向评分匹配(1:1)后,每组各有34例患者(LMA-BB组和SLT+BB组)。比较两组之间的关键指标,包括气道压力、通气和氧合参数、肺顺应性、术后恢复情况及并发症。匹配后,两组的基线特征相似。LMA-BB组在气道压力管理方面具有显著优势,其峰值和平台压较低(P<0.05)。LMA-BB组的通气和氧合效率更高,包括更低的呼气末二氧化碳分压(37.8±4.7 vs 39.2±5.1 mmHg,P=0.04)和更高的氧合指数(255±22 vs 245±28,P=0.04)。肺顺应性得到改善(P=0.018),LMA-BB组更多患者实现了良好的肺萎陷(76.5% vs 52.9%,P=0.032)。此外,术后恢复更快,拔管时间更短(12.4±3.2 vs 14.8±3.6分钟,P=0.003),并发症更少,包括低氧血症(5.9% vs 23.5%,P=0.027)和肺部问题(8.8% vs 20.6%,P=0.046)。在胸科OLV中,LMA-BB技术相较于传统的SLT+BB方法具有显著的临床优势,包括改善气道管理、通气效率、肺顺应性以及更快的恢复。它还减少了术后并发症,使其成为胸外科手术的一个有前景的替代方案。