These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: [Impacts of different methods in laryngeal mask airway positioning on the airway management of elderly patients with general anesthesia].
    Author: Yan F, Li J, Wang HJ, Yang X, Yang JB, Tu XJ.
    Journal: Zhonghua Yi Xue Za Zhi; 2018 May 15; 98(18):1424-1429. PubMed ID: 29804406.
    Abstract:
    Objective: By observing the clinical effect of ultrasound, fiberoptic bronchoscopy and traditional standard in positioning the general anesthesia of laryngeal mask ventilation in elderly patients, the superiority of laryngeal mask positioning with visualization technique of ultrasound and fiberoptic bronchoscope on airway management in elderly patients with general anesthesia was analyzed. Methods: One hundred and twenty cases of elderly patients with general anesthesia of laryngeal mask ventilation from the People's Hospital of Yuyao city from October 2016 to October 2017 were selected and randomly divided into 3 groups(n=40)according to American Society of Anesthesiologists (ASA) grading criteria Ⅰ-Ⅲ. Group A: traditional standard positioning laryngeal mask group. Group B: fiberoptic bronchoscope positioning laryngeal mask group. Group C: ultrasound positioning laryngeal mask group. The general information of sex ratio of male and female, mass, and height, and operation type, operation duration, anaesthesia duration, and modified Mallampati grade were observed and compared among the three groups. The number of successful laryngeal mask ventilation after laryngeal mask placement in 3 groups was observed, the laryngeal mask placement time (T(0)) and the normal ventilation time after adjustment (T(1)) in each group were recorded, and the first success rate of laryngeal mask placement, the success rate after adjusting the positioning, and the success rate of re-placement were calculated. Moreover, the mean peak airway pressure at 5 min after operation, the minimum intrathecal injection gas for minimum ventilation (V(min)), the minimum laryngeal mask intravesical pressure (ICP(min)), and the lowest air pressure for oral and pharyngeal leakage (OLP(min)) were recorded. The airway seal pressure (OLP(60)) and the volume of gas injection (V(60)) when the intravesical pressure was 60 cmH(2)O (1 cmH(2)O=0.098 kPa) were used to record the incidence of postoperative laryngeal mask bleeding, cough, nausea and vomiting, and the incidence of pharyngalgia, odynophagia, hoarseness and other related complications after 24 hours of the operation. Results: There was no significant difference in general information, airway evaluation and anesthesia operation among the three groups (all P>0.05). The incidence of intraoperative laryngeal mask bleeding in group B and C was 7.9% and 2.6% respectively, the incidence of odynophagia at 24 hours after operation was 5.3% and 0 respectively, and the incidence of pharyngalgia and hoarseness was 18.4% and 7.9% respectively, less than that in group A (24.2%, 12.1% and 36.3%). The difference was statistically significant (χ(2)=8.900, 6.880, 9.000, P<0.05). The success rate of adjustment and positioning after the placement of laryngeal mask was 84.2% and 94.7% respectively in group B and C, higher than that in group A of 72.7%, and the difference was statistically significant (χ(2)=6.500, P<0.05). The lowest laryngeal mask intralaryngeal pressure for ventilation in group B and C was (35.39±4.67) cmH(2)O and (32.61±3.22) cmH(2)O, lower than that in group A of (39.30 ± 5.93) cmH(2)O, the intralaryngeal pressure was 60 cmH(2)O, and the airway seal pressure was (25.82±4.48) cmH(2)O and (28.34±6.99) cmH(2)O, higher than that in group A of (22.45±4.98) cmH(2)O, which was significantly different (F=18.200, 9.720, P<0.05). Conclusions: In elderly patients with general anesthesia, it is feasible to manage the airway by ultrasound or fiberoptic bronchoscopy with laryngeal mask. Ultrasound positioning laryngeal mask improves the accuracy of the intraoperative ventilation, and reduces the incidence of postoperative airway related complications. 目的： 通过对超声、纤维支气管镜(纤支镜)、传统标准3种方法定位老年患者喉罩通气全身麻醉的临床效果的观察，分析可视化技术超声、纤支镜的喉罩定位对老年全麻患者气道管理的优越性。 方法： 选取余姚市人民医院2016年10月至2017年10月120例老年全麻喉罩通气患者，美国麻醉医师协会分级(ASA)标准Ⅰ～Ⅲ级，采用随机数字表法分为3组(n＝40)：A组：传统标准定位喉罩组；B组：纤支镜定位喉罩组；C组：超声定位喉罩组。观察比较3组患者男女性别比、体质量、身高等一般情况及手术类型、手术时长、麻醉时长、ASA分级、改良Mallampati分级等情况；观察3组喉罩置入定位后喉罩正常成功通气例数，记录每组患者喉罩置入时间(T(0))、调整后正常通气的时间(T(1))、计算喉罩置入首次成功率、调整定位后成功率、重新置入后成功率，观察记录手术后5 min平均气道峰压、满足最低通气的囊内注射气体最少毫升数(V(min))、最低喉罩囊内压(ICP(min))及最低口咽漏气压(OLP(min))；当囊内压为60 cmH(2)O(1 cmH(2)O＝0.098 kPa)时的气道密封压(OLP(60))和注射气体体积(V(60))，观察记录术后喉罩沾血率、呛咳、恶心呕吐情况，记录术后24 h咽痛、吞咽痛、声嘶等相关并发症的发生率。 结果： 3组患者一般资料情况、气道评估情况、麻醉手术情况差异均无统计学意义(均P>0.05)；B、C两组术中喉罩沾血率为7.9%、2.6%，术后24 h吞咽痛发生率为5.3%、0，咽痛、声嘶发生率为18.4%、7.9%，少于A组的24.2%、12.1%、36.3%，差异均有统计学意义(χ(2)＝8.900、6.880、9.000，均P<0.05)；B、C两组喉罩置入后调整定位成功率为84.2%、94.7%，高于A组的72.7%，差异有统计学意义(χ(2)＝6.500，P<0.05)；B、C两组通气的最低喉罩囊内压为(35.39±4.67)、(32.61±3.22)cmH(2)O，低于A组的(39.30±5.93)cmH(2)O，囊内压60 cmH(2)O气道密封压为(25.82±4.48)、(28.34±6.99)cmH(2)O，高于A组的(22.45±4.98)cmH(2)O，差异有统计学意义(F＝18.200、9.720，均P<0.05)。 结论： 在老年全麻患者中超声或者纤支镜定位喉罩管理气道是可行的，超声定位喉罩，术中通气更加精确化，降低了术后气道相关并发症的发生率。.
    [Abstract] [Full Text] [Related] [New Search]