Wehrle H J, Gottstein P
Abteilung für Anästhesie und Intensivmedizin, Evang. Diakonissenkrankenhaus Karlsruhe-Rüppur.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1997 Mar;32(3):151-4. doi: 10.1055/s-2007-995029.
This is a report on experiences regarding the use of the reinforced laryngeal mask airway for 121 minor operations in paediatric otolaryngology. By far the most interventions were adeno-tonsillectomies (104), which until now were performed under general anaesthesia with tracheal intubation.
The rate of observed complications was surprisingly low. 117 children were able to undergo their operation using the laryngeal mask airway. Tracheal intubation became necessary four times (failure to bring laryngeal mask into position occurred twice, laryngospasm occurred once, cough/pressing caused by lack of adequate depth of anaesthesia in two cases). In five cases there were problems of ventilation (4.1%), provoked by the Boyle-Davis gag. Seven children complained of postoperative sore throat, a complication that could be avoided later by measuring the cuff pressure (25-70 cm H2O). Aspiration was not observed in any of the cases. The complete absence of choking or pressing was regarded as particularly favourable by both the anesthetist and the surgeon.
The use of the reinforced laryngeal mask airway during paediatric otolaryngological operations in the hand of an experienced anaesthetist appears to be a promising alternative to tracheal intubation and merits more widespread use.
本文报告了在小儿耳鼻喉科121例小手术中使用加强型喉罩气道的经验。到目前为止,大多数手术是腺样体扁桃体切除术(104例),此前这些手术均在全身麻醉下进行气管插管。
观察到的并发症发生率出奇地低。117名儿童能够使用喉罩气道进行手术。有4次需要进行气管插管(两次未能将喉罩放置到位,一次发生喉痉挛,两例因麻醉深度不足引起咳嗽/按压)。有5例出现通气问题(4.1%),由博伊尔-戴维斯开口器引发。7名儿童术后抱怨喉咙痛,这种并发症后来通过测量套囊压力(25 - 70 cm H₂O)可以避免。所有病例均未观察到误吸。麻醉师和外科医生都认为完全没有呛咳或按压是特别有利的。
在经验丰富的麻醉师手中,小儿耳鼻喉科手术中使用加强型喉罩气道似乎是气管插管的一个有前景的替代方法,值得更广泛地应用。