喉管抽吸一次性(LTS-D)和最高喉罩气道(SLMA)是第二代声门上气道装置(SAD),具有增加的通道以允许胃引流。我们研究了在全身麻醉中使用压力控制机械通气进行中短期手术时这些设备的功效,并比较了不同头颈部位置的口咽密封压力。
每组80例患者接受LTS-D或SLMA进行气道管理。患者在两个不同的机构中招募。主要结果变量是中性口咽密封压力,屈曲,扩展,左右头颈位置。次要结果变量是达到有效气道的时间,易于插入,尝试次数,插入期间必要的机动,通气参数,胃管插入的成功率和并发症的发生率。
使用LTS-D获得的口咽密封压力高于SLMA,(延伸(p=0.0150)和正确的位置(p=0.0268,在60cmH2O内压力下,p=0.0268,在中立位置几乎显着(p=0.0571)。与SLMA相比,颈部伸展期间LTS-D的口咽密封压力显着升高(p=0.015)。每个装置在所有其他位置检测到相似的口咽密封压力。两组的次要结局具有可比性。使用LTS-D通气的患者喉咙痛的发生率更高(p=0.527)。无重大并发症发生。
LTS-D在头颈部右侧和伸展位置获得了更好的口咽密封压力,尽管在改变中立位置使用压力控制机械通气的管理方面似乎没有意义。SLMA的光纤视图更好。LTS-D术后喉咙痛发生率较高。
ClinicalTrials.govID:NCT02856672,唯一协议ID:BnaiZionMC-16-LG-001,注册时间:2016年8月。
The Laryngeal Tube Suction Disposable (LTS-D) and the Supreme Laryngeal Mask Airway (SLMA) are second generation supraglottic airway devices (SADs) with an added channel to allow gastric drainage. We studied the efficacy of these devices when using pressure controlled mechanical ventilation during general anesthesia for short and medium duration surgical procedures and compared the oropharyngeal seal pressure in different head and-neck positions.
Eighty patients in each group had either LTS-D or SLMA for airway management. The patients were recruited in two different institutions. Primary outcome variables were the oropharyngeal seal pressures in neutral, flexion, extension, right and left head-neck position. Secondary outcome variables were time to achieve an effective airway, ease of insertion, number of attempts, maneuvers necessary during insertion, ventilatory parameters, success of gastric tube insertion and incidence of complications.
The oropharyngeal seal pressure achieved with the LTS-D was higher than the SLMA in, (extension (p=0.0150) and right position (p=0.0268 at 60 cm H2O intracuff pressures and nearly significant in neutral position (p = 0.0571). The oropharyngeal seal pressure was significantly higher with the LTS-D during neck extension as compared to SLMA (p= 0.015). Similar oropharyngeal seal pressures were detected in all other positions with each device. The secondary outcomes were comparable between both groups. Patients ventilated with LTS-D had higher incidence of sore throat (p = 0.527). No major complications occurred.
Better oropharyngeal seal pressure was achieved with the LTS-D in head-neck right and extension positions , although it did not appear to have significance in alteration of management using pressure control mechanical ventilation in neutral position. The fiberoptic view was better with the SLMA. The post-operative sore throat incidence was higher in the LTS-D.
ClinicalTrials.gov ID: NCT02856672 , Unique Protocol ID:BnaiZionMC-16-LG-001, Registered: August 2016.