Brimacombe J, Keller C
Department of Anaesthesia and Intensive Care, Cairns Base Hospital, Australia. 100236,
Anesth Analg. 1998 Dec;87(6):1379-82. doi: 10.1097/00000539-199812000-00032.
We measured pharyngeal mucosal pressures at six different locations on the laryngeal mask airway (LMA) and tested the hypothesis that the efficacy of the seal is not related to pharyngeal mucosal pressure. Twenty anesthetized, paralyzed adult patients were studied. Microchip sensors were attached to the size 5 LMA at locations corresponding to the lateral and posterior pharynx, the hypopharynx, the pyriform fossa, the base of tongue, and the oropharynx. Mucosal pressures and airway sealing pressures were recorded during inflation of the cuff from 0 to 40 mL in 10-mL increments. The highest mean mucosal pressure was in the oropharynx (26 cm H2O), and the lowest was in the posterior pharynx (2 cm H2O). Mucosal pressures increased with increasing intracuff pressure and cuff volume, but the rate of increase varied among locations. Airway sealing pressure increased with increasing intracuff volume from 0 to 10 mL (P < 0.0001) and 10 to 20 mL (P = 0.0001), was unchanged from 20 to 30 mL, and decreased from 30 to 40 mL (P = 0.005). The airway sealing pressure was higher than pharyngeal mucosal pressure until the intracuff volume was > or =30 mL. There was no correlation between mucosal pressures and airway sealing pressure at any location. We conclude that the efficacy of the seal is not related to pharyngeal mucosal pressure. Pharyngeal mucosal pressures are generally lower than those considered safe for the tracheal mucosa during prolonged intubation.
We measured pharyngeal mucosal pressures at six different locations on the laryngeal mask airway and showed that the efficacy of the seal is not related to pharyngeal mucosal pressure. Pharyngeal mucosal pressures are generally lower than those considered safe for the tracheal mucosa during prolonged intubation.
我们在喉罩气道（LMA）的六个不同位置测量了咽黏膜压力，并检验了密封效果与咽黏膜压力无关这一假设。对20例麻醉、麻痹的成年患者进行了研究。将微芯片传感器附着于5号LMA上对应咽外侧和后部、下咽、梨状窝、舌根及口咽的位置。在袖带以10 mL增量从0充气至40 mL的过程中记录黏膜压力和气道密封压力。平均黏膜压力最高的是口咽（26 cm H₂O），最低的是咽后部（2 cm H₂O）。黏膜压力随袖带内压力和袖带容积增加而升高，但不同位置的升高速率不同。气道密封压力在袖带容积从0增加至10 mL（P < 0.0001）和10至20 mL（P = 0.0001）时升高，在20至30 mL时不变，在30至40 mL时降低（P = 0.005）。直到袖带容积≥30 mL时，气道密封压力才高于咽黏膜压力。在任何位置，黏膜压力与气道密封压力之间均无相关性。我们得出结论，密封效果与咽黏膜压力无关。在长时间插管期间，咽黏膜压力通常低于气管黏膜被认为安全的压力。
我们在喉罩气道的六个不同位置测量了咽黏膜压力，并表明密封效果与咽黏膜压力无关。在长时间插管期间，咽黏膜压力通常低于气管黏膜被认为安全的压力。
