Pitti R, Barriot P, Ladagnous J F, Giraud D, Hohl B
Département d'Anesthésie-Réanimation, HIA Legouest, Metz Armées.
Cah Anesthesiol. 1995;43(4):393-6.
Airway control and maintenance of effective assisted ventilation are an absolute priority in emergency medicine. Developed by Brain in 1988, the laryngeal mask offers a new means of ventilation management and is a reliable compromise between the face mask and endotracheal tubing. The laryngeal mask ensures no protection against gastric contents inhalation and its use is limited in patients with decreased thoracopulmonary compliance. However, compared to the face mask, the laryngeal mask offers several benefits in the management of cardiorespiratory arrests by paramedical staff and rescue teams: the procedure is easy to learn, the device improves airway patency, leaves the operator's hands free, allows endotracheal aspiration to be performed and reduces the risk of hyperinsufflation. These advantages make the use of the laryngeal mask a technique which should be taught to any staff liable to face and manage cases of cardiorespiratory arrest. The laryngeal mask cannot and does not replace endotracheal tubing which remains the only technique that guarantees upper airway patency and protection as well as efficient ventilation control. However, in some situations tubing may prove difficult and even, at times, impossible to perform. This is when the laryngeal mask will come in handy, either as a temporary solution or as an alternative to difficult or impossible tubing techniques.
气道控制和维持有效的辅助通气是急诊医学中的绝对优先事项。喉罩由Brain于1988年研发，提供了一种新的通气管理手段，是面罩和气管内导管之间可靠的折衷方案。喉罩不能防止胃内容物吸入，并且在胸肺顺应性降低的患者中其使用受到限制。然而，与面罩相比，喉罩在医护人员和救援团队对心肺骤停的处理中具有几个优点：该操作易于学习，该装置可改善气道通畅性，使操作者双手得以解放，允许进行气管内吸引并降低通气过度的风险。这些优点使得喉罩的使用成为一项应传授给任何可能面对和处理心肺骤停病例的工作人员的技术。喉罩不能也不会取代气管内导管，气管内导管仍然是保证上气道通畅、保护以及有效通气控制的唯一技术。然而，在某些情况下，插入导管可能会很困难，甚至有时是不可能的。这时喉罩就会派上用场，既可以作为临时解决方案，也可以作为困难或无法进行导管插入技术的替代方法。
