Supreme喉罩和Unique喉罩用于学龄儿童全身麻醉气道管理的比较  

A comparison of airway mamagement between laryngeal mask airway-Supreme and laryngeal mask airway-Unique in school-age children with general anesthesia

作　　者：田悦[1] 张丽红[1] 李璐[1] 李云峰[1] 

机构地区：[1]中国医科大学附属盛京医院麻醉科,辽宁沈阳110004

出　　处：《上海医学》2013年第8期676-679,共4页Shanghai Medical Journal

摘　　要：目的比较Supreme喉罩和Unique喉罩用于学龄儿童全身麻醉气道管理的效果。方法选取拟行骨科手术的患儿60例,美国麻醉医师学会分级Ⅰ或Ⅱ级,年龄10～13岁,体重30～40kg,随机分入Supreme喉罩组和Unique喉罩组,每组30例。两组均选用3号喉罩,Supreme喉罩组于置入后经引流管放置12号胃管1根,两组均应用纤维支气管镜检查通气口与声门对位情况。记录喉罩置入成功率、置入难易度、操作时间、气道密封压、胃内充气发生率、通气口与声门对位和术中气道通畅度分级、手法调整情况、呼吸道并发症发生情况。Supreme喉罩组另记录放置胃管情况。结果与Unique喉罩组比较,Supreme喉罩组的操作时间显著延长(P<0.05),气道密封压显著升高(P<0.01),胃内充气发生率显著降低(P<0.05)。两组间置入难易度分级、置入成功率、通气口与声门对位分级、术中气道通畅度分级、手法调整情况,及拔除喉罩期间和术后24h内各类并发症发生率的差异均无统计学意义(P值均>0.05)。结论 Supreme喉罩和Unique喉罩均可用于学龄儿童全身麻醉的气道管理,Supreme喉罩的气道密封压更高、胃内充气发生率更低,对术中需要胃排空的患儿会更为有利。Objective To compare the efficacies of the laryngeal mask airway-Supreme with the laryngeal mask airway-Unique in school-age children during general anesthesia. Methods Sixty children, American Society of Anesthesiologists （ASA） I - Ⅱ , aged 10 to 13 years, weighing 30- 40 kg, undergoing orthopaedic surgery were randomly divided into two groups. 3. 0 laryngeal mask airway-Supreme and 3. 0 laryngeal mask airway-Unique were inserted in group S and U （each n = 30）, respectively. A gastric tube was placed through the drainage tube in group S. Fiberoptic bronchoscope was used to examine the insertion. Insertion time, achievement rate, airway leak pressure, incidence of gastric insufflations, quality of airway and respiratory tract complications were measured. Results Compared with group U, insertion time was significantly prolonged （ P^0.05）, airway leak pressure was significantly increased （ P^0.01 ）, and the incidence of gastric insufflation was significantly decreased in group S （ P^0.05）. There were no significant differences in terms of the difficulty of insertion, achievement rate of insertion, quality of airway or complications between two groups （all P^0.05）. Conclusion Both laryngeal mask airway-Supreme and laryngeal mask airway-Unique can be used for airway maintenance in school-age children during general anesthesia. With high airway leak pressure and low incidence of gastric insufflations, emptying. （Shangha laryngeal mask airway-Supreme is more suitable for the patients who require gastric Med J, 2013, 36： 676-679）

关 键 词：喉面罩 麻醉 全身 儿童 

分 类 号：R726.1[医药卫生—儿科]