在妇科腹腔镜手术下比较不同种类喉罩的功效

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Comparison of the efficacy of different types of laryngeal mask airways in patients undergoing laparoscopic gynecological surgery

在妇科腹腔镜手术下比较不同种类喉罩的功效

OBJECTIVE:

目的：

To compare the efficacy of laryngeal mask airway Supreme, ProSeal and I-gel in patients undergoing laparoscopic gynecological surgery.

在妇科腹腔镜手术下比较LMA Supreme, ProSeal 和 I-gel 无囊双腔喉罩的功效

METHODS:

方法：

From Jan 2010 to Sep 2012 in Beijing Hospital, approved by hospital ethics committee, ninety ASA IorII patients, aged 21-64 yr, weighing 45-90 kg, undergoing laparoscopic gynecological surgery, were randomized into 3 groups (n = 30 each): LMA Supreme group (group S), LMA ProSeal group (group P)and LMA I-gel group (group I). Anesthesia was induced with target-controlled infusion. After the patients lost consciousness, rocuronium 0.6 mg/kg was given to facilitate the LMA insertion. A gastric tube was inserted through the drain tube of the LMA. The LMA placement time, the number of attempts of LMA insertion, the number of attempts of gastric tube placement, the airway sealing pressure, the parameters of ventilation, and complications were recorded. The fiberoptic laryngoscopy scores were assessed after LMA placement. The anesthesia time and recovery time were also recorded.

在北京医院从2010年1月至2012年9月，经过批准，年龄在21到64岁；体重在45-90公斤的90位需要接受妇科腹腔镜手术的患者被随机分成3组。分别用LMA Supreme, LMA ProSeal 和I-gel进行手术。麻醉引导使用复合灌注。直到患者失去知觉后，以0.6毫克/公斤速率输入罗库溴铵来帮助喉罩置入。胃管通过喉罩上的导管置入。喉罩的置入时间，置入尝试的次数，胃管置入尝试次数，密封压，通气参数，以及并发症被记录下来。在喉罩置入后进行喉镜检查评估。
麻醉时间和恢复时间也同样被记录下来。

RESULTS:

结果：

There was no significant difference in the anesthesia time, recovery time, fiberoptic bronchoscopy scores among the three groups (P > 0.05). Parameters of ventilation in each group were normal. The success rates of LMA and gastric tube placement were 100% in each group. The airway sealing pressure in S, P and I groups were 25 ± 5 cm H2O, 32 ± 5 cm H2O, 30 ± 6 cm H2O respectively, the airway sealing pressure was significantly higher in group P and group I, compare with group S (P < 0.05). The LMA placement time in S, P and I groups were 8 ± 4s, 10 ± 5s, 8 ± 3s respectively.

三组在麻醉时间，恢复时间以及纤支镜使用考评上都没有明显的区分。每组的通气参数正常。每组的喉罩以及其胃管置入成功率都为100%。LMA Supreme 的密封压为 25 ± 5 cm H2O，LMA Proseal的密封压为32 ± 5 cm H2O，i-gel的密封压为30 ± 6 cm H2O，i-gel 和 Proseal 的密封压明显高于前者。三者的置入时间分别为：8 ± 4s, 10 ± 5s, 8 ± 3s。

CONCLUSIONS:

结论：

The three LMA can all be used effectively for gynecological laparoscopic surgery. LMA I-gel can provide higher airway sealing pressure. LMA I-gel provides adequate ventilation during operation with fewer complications.

三种喉罩都可用于妇科腹腔镜手术中。I-gel 可以提供更高的密封压, 并且其在手术中能提供充分得通气以及带来更少的并发症。