Verghese C, Brimacombe J R
Department of Intensive Care and Anaesthesia, Royal Berkshire Hospital, United Kingdom.
Anesth Analg. 1996 Jan;82(1):129-33. doi: 10.1097/00000539-199601000-00023.
A survey of laryngeal mask airway (LMA) usage was conducted to provide general information about safety and efficacy with special emphasis on controversial issues such as positive pressure ventilation (PPV), prolonged anesthesia, and laparoscopic and nonlaparoscopic intraabdominal surgery. During the 2-yr study period, of the 39,824 patients who underwent general anesthesia, 11,910 (29.9%) patient airways were managed with the LMA. Forty-four percent underwent PPV. Placement was successful in 99.81%, and in 23 patients the LMA was abandoned in favor of the tracheal tube (TT). Use of the LMA for any intraabdominal procedure was considered nonconventional and occurred in 2222 (18.7%) patients. On 579 occasions procedures lasted > 2 h. A total of 44 critical incidents were documented. Eighteen (0.15%) were related to the airway and none required intensive care management. There were 26 critical incidents not related to the airway which resulted in two admissions to the intensive care unit and one death. There were three cases of failed tracheal intubation managed with the LMA. This survey demonstrates that the LMA technique is safe and effective for both spontaneous and controlled ventilation. Use of the LMA for gynecologic laparoscopy, gynecologic laparotomy, and procedures > 2 h also appears safe.
开展了一项关于喉罩气道（LMA）使用情况的调查，以提供有关安全性和有效性的一般信息，特别强调了诸如正压通气（PPV）、长时间麻醉以及腹腔镜和非腹腔镜腹部手术等有争议的问题。在为期2年的研究期间，在接受全身麻醉的39824例患者中，11910例（29.9%）患者的气道采用LMA管理。44%的患者接受了PPV。置入成功率为99.81%，23例患者放弃使用LMA而改用气管导管（TT）。在任何腹部手术中使用LMA被认为是非常规的，发生在2222例（18.7%）患者中。手术持续时间>2小时的情况有579次。共记录了44起严重事件。18起（0.15%）与气道有关，无一例需要重症监护管理。有26起与气道无关的严重事件，导致2例患者入住重症监护病房，1例死亡。有3例气管插管失败后采用LMA处理。这项调查表明，LMA技术对于自主通气和控制通气都是安全有效的。在妇科腹腔镜手术、妇科剖腹手术以及手术时间>2小时的手术中使用LMA似乎也是安全的。
