SaCoVLM^(TM)可视喉罩与Ambu®Aura‑Gain喉罩联合可视软镜引导小儿气管插管的随机对照研究  

A randomized controlled trial comparing SaCoVLM^(TM)video laryngeal mask airway‑guided intubation with Ambu®Aura‑Gain laryngeal mask airway combined with fiberoptic bronchoscopy‑guided intubation in children

作　　者：陈莹 孔令玉 韩丁[1] 李泳鑫 陈凌宇 潘守东[1] Chen Ying;Kong Lingyu;Han Ding;Li Yongxin;Chen Lingyu;Pan Shoudong(Department of Anesthesiology,Children's Hospital,Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院麻醉科,北京100020

出　　处：《国际麻醉学与复苏杂志》2024年第12期1250-1255,共6页International Journal of Anesthesiology and Resuscitation

摘　　要：目的探讨SaCoVLM^(TM)可视喉罩与Ambu®Aura‑Gain喉罩联合可视软镜(FOB)引导气管插管在小儿全麻气道管理中的临床效果。方法择期行全麻手术的患儿100例,年龄1~6岁,美国麻醉医师协会(ASA)分级Ⅰ、Ⅱ级,马氏(Mallampati)分级Ⅰ、Ⅱ级,按随机数字表法分为两组(每组50例):SaCoVLM^(TM)可视喉罩组(SaCo组)和Ambu®Aura‑Gain喉罩联合可视软镜组(Ambu组)。SaCo组经可视喉罩引导直接进行气管插管,Ambu组经Ambu®Aura‑Gain喉罩联合可视软镜引导行气管插管。记录两组患儿一般资料。主要观察指标是气管插管成功的总时间(即喉罩置入时间+气管插管时间)。次要观察指标包括气管插管首次成功率,喉罩置入时间,喉罩置入次数,喉罩密封压,气管插管时间,声门暴露分级,入室时(T0)、喉罩置入前(T1)、喉罩置入后即刻(T2)、气管插管前(T3)、气管插管后1 min(T4)、气管插管后2 min(T5)、气管插管后5 min(T6)、拔管后即刻(T7)的血流动力学参数[平均动脉压(MAP)、心率、脉搏血氧饱和度(SpO2)],喉罩留置时间,拔管时间,喉罩和气管插管相关并发症(喉罩表面染血、导管染血、呛咳、低氧血症、咽痛、喉痉挛、吞咽困难及声音嘶哑等)。结果两组患儿一般资料差异均无统计学意义(均P>0.05)。与Ambu组比较,SaCo组患儿气管插管成功总时间和气管插管时间较短(均P<0.05),气管插管首次成功率和喉罩密封压较高(P<0.05),喉罩置入时间较长(P<0.05),T4时心率较低(P<0.05)。所有患儿均一次成功置入喉罩。两组患儿声门暴露分级、喉罩留置时间和拔管时间差异均无统计学意义(均P>0.05)。两组患儿T0~T3、T5~T7时心率及各时点MAP和SpO2差异均无统计学意义(均P>0.05)。拔除喉罩后,两组患儿喉罩表面染血、咽痛的发生率差异均无统计学意义(均P>0.05)。两组患儿均无导管染血、呛咳、喉痉挛、低氧血症、吞咽困难以及声音嘶哑等相关并�Objective To explore the clinical effect of SaCoVLM^(TM)video laryngeal mask airway and Ambu®Aura‑Gain laryngeal mask airway combined with fiberoptic bronchoscopy(FOB)for airway management in children under general anesthesia.Methods According to the random number table method,100 patients aged 1‒6 years,classified as American Society of Anesthesiologists physical status(ASA)ⅠorⅡand Mallampati gradeⅠorⅡ,were divided into two groups(n=50):the SaCoVLM™laryngeal mask airway‑guided intubation group(SaCo group)and the Ambu®Aura‑Gain combined with FOB group(Ambu group).In the SaCo group,tracheal intubation was performed directly under the guidance of video laryngeal mask airway.In the Ambu group,tracheal intubation was guided by Ambu®Aura‑Gain laryngeal mask airway combined with FOB.General data of two groups were recorded.Primary outcome is the total time to successful tracheal intubation.Secondary outcomes include the first‑attempt success rate of intubation,time of laryngeal mask insertion,number of laryngeal mask insertion,leakage pressure,time of intubation,glottis exposure grade,the hemodynamic variables[at admission to the operating room(T0),before laryngeal mask airway insertion(T1),immediately after laryngeal mask airway insertion(T2),before intubation(T3),1 minute after intubation(T4),2 minutes after intubation(T5),5 minutes after intubation laryngeal mask placement and tracheal intubation(including laryngeal mask airway and tracheal tube surface blood staining,choking,hypoxemia,sore throat,laryngospasm,dysphagia,hoarseness,etc).Results There was no significant difference in general data between the two groups(all P>0.05).Compared with the Ambu group,the SaCo group had shorter the total time of successful tracheal intubation and the time of intubation(all P<0.05),a higher first‑attempt success rate of intubation and a higher leakage pressure(P<0.05),a longer time for laryngeal mask airway insertion(P<0.05)and a lower heart rate at T4(P<0.05).Laryngeal mask airway was successfully in

关 键 词：小儿 SaCoVLM^(TM)可视喉罩 Ambu®Aura‑Gain喉罩 气管插管 气道管理 

分 类 号：R61[医药卫生—外科学]