PDF(Pubmed)
Abstract：
Adenoidectomy with or without tonsillectomy remains one of the most routinely performed surgical procedures in children. The duration of the procedure is usually less than half an hour and is done in a day surgery setting. Airway management for adenoidectomy can be especially challenging as the airway is shared between the surgeon and the anesthesiologist. The gold standard for airway management is an endotracheal tube (ETT), even though there has been an increase in the use of laryngeal mask airway (LMA) over the past decade. This retrospective study investigated patient data collected over a 4-year period (2016 to 2020). Data included 210 cases in a day surgery setting. We analyzed the choice of airway device and use of neuromuscular blockers and analgesics for pain management. The use of LMA was noted in 67.62% while endotracheal intubation was performed in 32.38% of cases. LMA resulted in fewer respiratory complications compared to ETT (p=0.006). The need for neuromuscular blockers was also lower in the LMA group (p=0.01). There was no statistically significant difference in the intraoperative dose of opioid analgesia (p=0.09). Flexible LMA is a satisfactory alternative to endotracheal intubation for outpatient pediatric adenoidectomy.
摘要：
有或没有扁桃体切除术的腺样体切除术仍然是儿童最常规的外科手术之一。该过程的持续时间通常少于半小时，并且在一天的手术环境中完成。腺样体切除术的气道管理可能特别具有挑战性，因为在外科医生和麻醉师之间共享气道。气道管理的金标准是气管内导管（ETT），尽管在过去十年中喉罩气道（LMA）的使用有所增加。这项回顾性研究调查了4年（2016年至2020年）收集的患者数据。数据包括210例日间手术设置。我们分析了气道装置的选择以及神经肌肉阻滞剂和镇痛药在疼痛管理中的使用。在67.62％的病例中使用了LMA，而在32.38％的病例中进行了气管插管。与ETT相比，LMA导致更少的呼吸系统并发症（p=0.006）。LMA组中对神经肌肉阻断剂的需求也较低(p=0.01)。术中阿片类镇痛剂量差异无统计学意义(p=0.09)。柔性LMA是门诊小儿腺样体切除术气管插管的令人满意的替代方法。
