Patel Roushan, Anand Rishi, Nag Deb Sanjay, Sen Biswajit, Gope Roshan Lal, Barman Tapas
Anesthesiology, Tata Main Hospital, Jamshedpur, IND.
Anesthesiology, Manipal Tata Medical College, Jamshedpur, IND.
Cureus. 2025 May 18;17(5):e84376. doi: 10.7759/cureus.84376. eCollection 2025 May.
Background and aims Pneumoperitoneum and extreme Trendelenburg position in laparoscopic surgeries require ventilation at higher peak pressure, potentially resulting in peritubular leak and difficult ventilation. Our study aimed to assess whether a throat pack can provide an adequate seal to prevent peritubular leak around uncuffed tube pediatric laparoscopic surgeries as compared to a Microcuff® tube. Methods This randomized clinical trial was carried out on 94 children aged between eight months and five years undergoing laparoscopic surgery under general anesthesia allocated in two parallel groups using a computer-generated random number. We compared sealing pressure, peritubular leak, adequacy of ventilation, quality of capnography, and post-extubation laryngospasm or stridor. Results The uncuffed tube with a throat pack effectively seals the airway, and neither the creation of pneumoperitoneum nor the Trendelenburg position affected ventilation or the seal's effectiveness. There was no significant difference in the incidence of postoperative stridor between the two groups. Conclusion The throat pack provides an effective seal in an uncuffed tube to perform laparoscopic surgery without increasing airway morbidity.
腹腔镜手术中的气腹和极度头低脚高位需要更高的峰值压力通气，这可能导致肾小管周围渗漏和通气困难。我们的研究旨在评估与Microcuff® 导管相比，喉罩在无套囊导管小儿腹腔镜手术中能否提供足够的密封以防止肾小管周围渗漏。方法：这项随机临床试验对94名年龄在8个月至5岁之间、在全身麻醉下接受腹腔镜手术的儿童进行，使用计算机生成的随机数将其分为两个平行组。我们比较了密封压力、肾小管周围渗漏、通气充分性、二氧化碳波形图质量以及拔管后喉痉挛或喘鸣情况。结果：带有喉罩的无套囊导管能有效密封气道，气腹的建立和头低脚高位均未影响通气或密封效果。两组术后喘鸣的发生率无显著差异。结论：喉罩在无套囊导管中能提供有效的密封，以进行腹腔镜手术而不增加气道发病率。
