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出 处:《麻醉与镇痛》2013年第1期24-28,共5页Anesthesia & Analgesia
摘 要:背景I-gel喉罩是一种不带充气套囊的声门上通气道,其设计允许气管导管无障碍通过,且既往研究已表明其能与声门进行良好对位。在本前瞻性随机临床试验中,我们比较了经i-gel喉罩和LMA Fastrach喉罩辅助进行气管插管盲插的成功率。方法将160例需行全身麻醉和气道管理的患者随机分为2组,每组分别进行经i-gd喉罩或LMAFastrach喉罩辅助的气管插管。全麻诱导后,每组患者置入相应喉罩并确认有效肺通气,随后进行气管导管盲插。观测气管插管次数并计算首次插管成功率和最终插管成功率。结果每组各入选80例患者。i-gel喉罩辅助插管组首次插管成功率为69%,而LMA Fastrach喉罩辅助插管组为74%(差异的95%可信区间CI为-9%-19%,P=0.60)。l-gel喉罩组的最终插管成功率低于LMAFastrach喉罩组(分别为73%和91%,差异的95%CI为7%。31%,P〈0.0001)。结论经i-gd喉罩或LMA Fastrach喉罩辅助气管导管盲插首次成功率相近,但首次插管失败后,i-gel喉罩并不提高后续插管成功率,且其最终插管成功率低于LMAFastrach喉罩。BACKGROUND: The i-gel^TM is a supraglottic airway device not requiring inflation of a cuff for lung ventilation. Its design allows for unobstructed passage of a tracheal tube and previous studies have demonstrated a favorable alignment with the glottic inlet. In this prospective randomized study, we compared the success rate of blind tracheal intubation using the i-gel and the laryngeal mask airway (LMA) FastrachTM. METHODS: One hundred sixty patients requiring general anesthesia and airway management were randomized to tracheal intubation using the i-gel or the LMA Fastrach. After induction of general anesthesia, the allocated device was inserted and adequate lung ventilation was confirmed. Blind tracheal intubation was then attempted. First attempt and overall tracheal intubation success rates were evaluated and tracheal intubation times were measured. RESULTS: Eighty patients were recruited in each study group. Successful tracheal intubation was obtained on the first attempt in 69% of patients with the i-gel and 74% of patients with the LMA Fastrach (95 % confidence interval [ CI ] of difference, - 9% to 19%, P = 0. 60). The overall intubation success rate was lower using the i-gel than it was using the LMA Fastrach (73 % vs 91%, 95 % CI of difference, 7 % to 3 1%, P 〈 0. 0001 ). CONCLUSIONS: On first attempts, successful blind tracheal intubation was obtained at comparable rates using the i-gel and the LMA Fastrach. However, when the first attempt was unsuccessful, subsequent attempts through the i-gel did not significantly increase tracheal intubation sumess rate. The LMA Fastrach yielded a higher overall intubation success rate.
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