在儿童中优化LMAProSeal插入:一项随机试验,比较视频鼻喉镜,直接鼻喉镜和标准技术
Hilal Dokmeci1, Yasemin B Ustun1, Esra Turunc2
1Department of Anesthesiology and Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun, Türkiye.
Minerva anestesiologica
|November 3, 2025
概括
视频喉科镜在儿童中提供了LMA ProSeal的优越放置,与直接喉科镜或标准技术相比,可以达到更高的口腔漏压力. 这种方法提高了儿童患者的呼吸道装置的有效性.
科学领域:
- 麻醉学 麻醉学
- 儿科气道管理 儿童气道管理
- 医疗器械 医疗器械
背景情况:
- 确保在儿童中使用supraglottic气道装置 (SAD) 进行有效的通风是具有挑战性的.
- 像LMA ProSeal这样的第二代SAD需要精确的放置才能达到最佳功能.
- 儿科患者在插入气道装置时存在独特的解剖学考虑.
研究的目的:
- 为了比较三种LMAProSeal插入技术在儿科患者中的有效性.
- 评估标准技术,直接喉腔镜和视频喉腔镜对口腔漏压力 (OLP) 的影响.
- 评估每种技术的光纤眼球视图和插入成功率.
主要方法:
- 一项前性,随机化,受控试验,涉及150名1-10岁儿童.
- 使用标准技术的LMA ProSeal插入,直接喉腔镜 (DL) 或视频喉腔镜 (VL).
- 通过光纤支气管支气管镜测量OLP和评估眼视图.
主要成果:
- 视频喉腔镜 (VL) 与直接喉腔镜 (DL) (23 cmH2O) 和标准技术 (SD) (21 cmH2O) 相比,显著提高了OLP (26 cmH2O).
- 此外,VL还提供了优异的光纤成像得分和与DL相比的第一次尝试成功率 (94%).
- 与SD相比,VL和DL的插入时间较长,VL和DL之间的额外机动类似.
结论:
- 视频鼻镜确保了优越的LMA ProSeal在儿童中的放置,由更高的OLP和更好的光纤视图证明.
- 直接喉腔镜比标准技术提供了改进,但效果不如视频喉腔镜.
- 建议VL用于优化SAD放置和儿童麻醉中通风的有效性.
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