Supreme与Flexible喉罩通气罩内压对气道漏气压的影响

Impact of Cuff Pressure on Airway Leak Pressure in Laryngeal Mask Airway Supreme and Flexible

目的探讨Supreme喉罩和Flexible喉罩不同通气罩内压对气道漏气压的影响。方法择期全麻乳腺手术患者,根据插入喉罩种类不同分为Supreme组(35例)和Flexible组(33例)。常规静脉麻醉诱导后由同一麻醉科医师插入Supreme或Flexible喉罩,确认位置良好,调整通气罩压力。分别记录通气罩压力为10、20、30、40、50 cm H2O(1 cm H2O=0.098 k Pa)时,两种喉罩的气道漏气压值。结果 Supreme组通气罩内压力20、30、40、50 cm H2O时,所对应的气道漏气压差异无统计学意义(P>0.05),但均显著高于10 cm H2O时气道漏气压(P<0.05);Flexible组通气罩内压力为30、40、50 cm H2O时,所对应的气道漏气压差异无统计学意义(P>0.05),但高于10、20 cm H2O时气道漏气压(P<0.05)。Supreme组患者的整体平均气道漏气压(25.40±5.52)cm H2O明显高于Flexible组的(20.67±3.06)cm H2O(P<0.05)。结论 Supreme喉罩的平均气道漏气压高于Flexible喉罩,达到最大平均气道漏气压时,Supreme喉罩所需的通气罩内压(20 cm H2O)低于Flexible喉罩(30 cm H2O)。

Objective To investigate the impact of cuff pressure on airway leak pressure in laryngeal mask airway （LMA） Supreme and Flexible.Methods Patients about to have elective breast surgery were divided into Supreme group （35 cases） and Flexible group （33 cases）.After general induction of anesthesia,LMA Supreme or Flexible was inserted by one anesthesiologist.We confirmed the LMA location,adjusted the cuff pressure,and recorded the peak airway leak pressures under different cuff pressures （10,20,30,40,and 50 cmH2O）.Results In Supreme group,peak airway leak pressures [（24.46 ± 5.43）,（25.11 ± 5.51）,（25.86 ±5.57）,（26.17 ±5.72） cmH2O] under 20,30,40,and 50 cmH2O cuff pressure showed no significant difference （P 〉0.05） between each other,but significantly higher than that under 10 cmH2O cuff pressure （20.80 ± 4.63） cmH2O （P 〈 0.05）.And in the Flexible group,peak airway leak pressures [（20.09±2.98）,（20.70±3.08）,（21.21 ±3.15） cmH2O] under30,40,50 cmH2O cuff pressure also showed no significant difference （P 〉 0.05） between each other,but significantly higher than those under 10 or 20 cmH2O cuff pressure [（17.52 ± 2.39）,（18.61 ± 2.42） cmH2O].Mean peak airway leak pressure [（25.40 ± 5.52） cmH2O] of LMA Supreme was significantly higher than that of LMA Flexible （20.67 ± 3.06） cmH2O （P 〈 0.05）.Conclusions Mean airway leak pressure of LMA Supreme is higher than LMA Flexible.The lowest cuff pressure to meet the tightness requirement with LMA Supreme is 20 cmH2O,which is lower than Flexible （30 cmH2O）.