An auto control comparison of the use of ProSeal laryngeal mask airway and standard laryngeal mask airway for positive pressure ventilation
- Author:
- No author available
- Journal Title:
- CHINESE CRITICAL CARE MEDICINE
- Issue:
- 2
- DOI:
- 10.3760/j.issn:1003-0603.2007.02.005
- Key Word:
- 食管引流型喉罩通气道;标准型喉罩通气道;间歇正压通气;气道密封压
Abstract： 目的 采用随机自身对照设计方法比较食管引流型喉罩通气道(PLMA)和标准型喉罩通气道(SLMA)用于间歇正压通气的有效性.方法 选择50例经美国麻醉医师协会(ASA)身体状态分级标准分为1～2级、拟在全身麻醉下实施择期整形外科手术患者.在常规麻醉诱导后,顺序插入PLMA和SLMA,将通气罩内压充气至60 cm H2O(1 cm H2O=0.098 kPa),评价两种喉罩通气道充气前后的肺通气满意度和气道密封压,同时进行光导纤维支气管镜(FOB)评分,确定通气罩的解剖位置.然后将潮气量设定为10 ml/kg实施间歇正压通气,记录间歇正压通气后连续5次呼吸的平均呼潮气量和平均吸气峰压.结果 在通气罩未充气情况下,插入PLMA后有46例(92%)患者获得了良好和尚可的肺通气效果,而插入SLMA后仅有22例(44%)患者获得了良好和尚可的肺通气效果;PLMA的气道密封压显著高于SLMA(P＜0.05).将通气罩内压充气至60 cm H2O,采用PLMA的50例患者均获得良好的肺通气效果,但采用SLMA时仅有28例获得良好的肺通气效果;PLMA所需的充气量和充气后获得的气道密封压均显著高于SLMA(P均＜0.05).采用PLMA时所有患者的气道密封压均高于或等于采用SLMA时;采用PLMA时除2例患者外,其他患者所需的充气量也均高于采用SLMA时.PLMA通气罩位置的FOB评分显著低于SLMA(P＜0.05).采用PLMA维持气道的29例患者和采用SLMA维持气道的21例患者的平均呼潮气量、吸气峰压及维持气道时间差异均无显著性(P均0.05).结论 与SLMA相比,PLMA可为正压通气提供更好的气道密封压,而且对声门和食管上端具有潜在的隔离作用,用于正压通气时PLMA比SLMA更有效、更安全.
- [1]蔺汝云,宋江萍,张静.喉罩：一种新型的气道管理方法[J].2004,(6).
- [2]毛鹏,薛富善,李成文,等.食管引流型与标准型喉罩通气道在全身麻醉患者的应用[J].2006,(9).
- [3]Joseph, Brimacombe,Christian, Keller,Bernd, Fullekrug,etc.A multicenter study comparing the ProSeal and Classic laryngeal mask airway in anesthetized, nonparalyzed patients.[J].2002,96(2).
- [4]C, Keller,J R, Brimacombe,K, Keller,etc.Comparison of four methods for assessing airway sealing pressure with the laryngeal mask airway in adult patients.[J].1999,82(2).
- [5]C K, Koay.A case of aspiration using the proseal LMA.[J].2003,31(1).
- [6]杨启,李立平.喉罩在急诊抢救中的应用[J].1997,(4).
- [7]Cornelius J, O'Connor,Michael S, Stix.Bubble solution diagnoses ProSeal insertion into the glottis.[J].2002,94(6).
- [8]Noel AG,Devitt JH,Ho-Tai LM,etc.Gas leak and gastric insufflation during controlled ventilation: face mask versus laryngeal mask airway.[J].1998,45(3).
- [9]A I, Brain,C, Verghese,P J, Strube.The LMA 'ProSeal'--a laryngeal mask with an oesophageal vent.[J].2000,84(5).
- [10]Shinichi, Kihara,Joseph, Brimacombe.Sex-based ProSeal laryngeal mask airway size selection: a randomized crossover study of anesthetized, paralyzed male and female adult patients.[J].2003,97(1).
- [11]Joseph, Brimacombe,Christian, Keller.Aspiration of gastric contents during use of a ProSeal laryngeal mask airway secondary to unidentified foldover malposition.[J].2003,97(4).
- [12]J, Brimacombe,A, Berry.A proposed fiber-optic scoring system to standardize the assessment of laryngeal mask airway position.[J].1993,76(2).
- [13]J, Brimacombe,C, Keller,M, Boehler,etc.Positive pressure ventilation with the ProSeal versus classic laryngeal mask airway: a randomized, crossover study of healthy female patients.[J].2001,93(5).
- [14]Shinichi, Kihara,Joseph R, Brimacombe,Yuichi, Yaguchi,etc.A comparison of sex- and weight-based ProSeal laryngeal mask size selection criteria: a randomized study of healthy anesthetized, paralyzed adult patients.[J].2004,101(2).
- [15]Joseph Brimacombe,Christian Keller.The ProSeal Laryngeal Mask AirwayA Randomized, Crossover Study with the Standard Laryngeal Mask Airway in Paralyzed, Anesthetized Patients[J].2000,93(1).
- [16]Keller C,Brimacombe J.Stability of the LMA-ProSeal and standard laryngeal mask airway in different head and neck positions: a randomized crossover study.[J].2003,20(1).
- [17]C, Keller,J, Brimacombe,A, Kleinsasser,etc.Does the ProSeal laryngeal mask airway prevent aspiration of regurgitated fluid?[J].2000,91(4).
- [18]J F, Hardy,Y, Lepage,N, Bonneville-Chouinard.Occurrence of gastroesophageal reflux on induction of anaesthesia does not correlate with the volume of gastric contents.[J].1990,37(5).