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在关节镜手术麻醉期间使用视野可调视频喉罩与气管插管进行气道管理的随机试验

Use of view-adjustable video laryngeal mask versus endotracheal intubation for airway management during anaesthesia for arthroscopic surgery: a randomized trial.

作者信息

Geng Chun-Jing, Su Guang-Lei, Deng Ying, Cong Zhu-Kai, Feng Dan-Dan, Zhang Si-Yuan, Cao Hai-Li, Zeng Hong

机构信息

Department of Anesthesia, Peking University Third Hospital, China.

Department of Anesthesia, Shanxi Provincial People's Hospital, China.

出版信息

Ann Med. 2025 Dec;57(1):2519683. doi: 10.1080/07853890.2025.2519683. Epub 2025 Jun 19.

Abstract

INTRODUCTION

The objective of this study was to compare the practicality and efficacy of utilizing a view-adjustable video laryngeal mask (SafeLM) versus endotracheal intubation (ETI) in the context of arthroscopic shoulder surgery.

PATIENTS AND METHODS

A randomized controlled trial enrolled 100 patients undergoing arthroscopic shoulder surgery, randomly assigned to the SafeLM group ( = 50) or ETI group ( = 50). The primary outcome measure was hemodynamic parameters, while mechanical ventilation parameters, complications, and the quality of anaesthesia recovery were considered as secondary outcomes. These parameters were then compared between the two groups.

RESULTS

During the intubation and extubation procedures, the SafeLM group demonstrated significantly lower mean arterial pressure and heart rate compared to the ETI group ( < 0.001). Furthermore, the airway pressure at T and T was notably lower in the SafeLM group compared to the ETI group ( < 0.001). However, there were no statistically significant differences in oxygen saturation observed between the two groups at any time point. Both groups were equally capable of quickly establishing a surgical airway when necessary. Notably, a smaller proportion of patients in the SafeLM group exhibited negative reactions during tube removal. Additionally, there was a statistically significant difference in the occurrence of post-operative sore throat, difficulty swallowing, choking, and coughing between the two groups ( < 0.001).

CONCLUSIONS

The utilization of SafeLM may result in enhanced regulation of blood pressure and heart rate among patients who undergo arthroscopic surgery for the shoulder while in the side decubitus position.

摘要

引言

本研究的目的是比较在肩关节镜手术中使用视野可调视频喉罩(SafeLM)与气管插管(ETI)的实用性和有效性。

患者与方法

一项随机对照试验纳入了100例接受肩关节镜手术的患者,随机分为SafeLM组(n = 50)或ETI组(n = 50)。主要观察指标为血流动力学参数,同时将机械通气参数、并发症及麻醉恢复质量视为次要观察指标。然后对两组之间的这些参数进行比较。

结果

在插管和拔管过程中,与ETI组相比,SafeLM组的平均动脉压和心率显著更低(P < 0.001)。此外,与ETI组相比,SafeLM组在T1和T2时的气道压力明显更低(P < 0.001)。然而,两组在任何时间点的血氧饱和度均无统计学显著差异。两组在必要时均能同样迅速地建立手术气道。值得注意的是,SafeLM组中出现拔管时不良反应的患者比例更小。此外,两组在术后咽痛、吞咽困难、呛咳和咳嗽的发生率方面存在统计学显著差异(P < 0.001)。

结论

在侧卧位进行肩关节镜手术的患者中,使用SafeLM可能会增强对血压和心率的调节。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbd1/12180316/78624fb1720a/IANN_A_2519683_F0001_C.jpg

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