BACKGROUND Paediatric supraglottic airway devices(SGAs)are widely used in routine anaesthesia and serve as primary or back-up devices for difficult airway management.The inflatable Ambu laryngeal masks and non-inflata...BACKGROUND Paediatric supraglottic airway devices(SGAs)are widely used in routine anaesthesia and serve as primary or back-up devices for difficult airway management.The inflatable Ambu laryngeal masks and non-inflatable i-gel are two improvements of SGAs based on classic laryngeal masks.The clinical performance and safety of these two devices in paediatric patients are still unclear and warrant further investigation.AIM To perform a systematic review and meta-analysis on the clinical performance and safety of Ambu laryngeal masks and i-gel in anaesthetised paediatric patients.METHODS MEDLINE,Embase,Web of Science and Cochrane Central Register of Controlled Trials were searched from inception dates to April 2020.We identified published randomised controlled trials(RCTs)in which the intervention involved the use of Ambu laryngeal masks and i-gel in anaesthetised paediatric patients(age<18 years).We assessed the oropharyngeal leak pressure(OLP)as the primary outcome.The secondary outcomes were insertion time,success rate of insertion on the first attempt,and incidence of adverse events.RESULTS After searching for all relevant trials published up to April 2020,data from seven RCTs with a total of 667 paediatric patients(323 and 344 participants in the i-gel and Ambu groups,respectively)were evaluated.The mean OLP in anaesthetised paediatric patients was lower in the Ambu group[21.82 cmH2O for Ambu vs 23.98 cmH2O for i-gel,P=0.003,95%confidence interval(CI):-3.58 to-0.75,I2=68%,Mantel-Haenszel random model].We did not find any clear evidence of differences between the devices in terms of insertion time,success rate of insertion,and incidence of adverse events except for blood staining(risk ratio 5.86,95%CI:1.76 to 19.46,P=0.004,I2=0,fixed-effect model).CONCLUSION The i-gel airway may provide a better seal and is therefore probably more suitable than the Ambu laryngeal mask airway in anaesthetised paediatric patients.However,the evidence is insufficient to allow making firm conclusions or to guide clinical practice,owing to the small number of relevant published studies.展开更多
This paper examines the directing, acting and rehearsal process in transforming the ancient Babylonian epic Gilgamesh for the stage using performers＇ journals as a means of determining the effect of corporeal non-wes...This paper examines the directing, acting and rehearsal process in transforming the ancient Babylonian epic Gilgamesh for the stage using performers＇ journals as a means of determining the effect of corporeal non-western styles on actors whose prior experience was almost exclusively in naturalistic and text-based theatre. The introduction of theatrical elements from multiple cultures including puppetry and the masks and techniques of Noh drama created a multi-tiered field for intercultural exchange. While Patrice Pavis＇s hourglass model for the transfer of theatrical material from a source to a target culture may hold true for productions that use linear modes of transmission, translation and incorporation of text, music, costumes and styles, its limitations make it necessary to posit alternative theories that take into account intercultural rehearsal practices, the collaboration of source and target culture and the dynamic interactions that take place through the agency of actor training in the fleshly physical theatre.展开更多
基金Supported by the Beijing Municipal Hospital Scientific Research Training Program,No.PX2017011。
文摘BACKGROUND Paediatric supraglottic airway devices(SGAs)are widely used in routine anaesthesia and serve as primary or back-up devices for difficult airway management.The inflatable Ambu laryngeal masks and non-inflatable i-gel are two improvements of SGAs based on classic laryngeal masks.The clinical performance and safety of these two devices in paediatric patients are still unclear and warrant further investigation.AIM To perform a systematic review and meta-analysis on the clinical performance and safety of Ambu laryngeal masks and i-gel in anaesthetised paediatric patients.METHODS MEDLINE,Embase,Web of Science and Cochrane Central Register of Controlled Trials were searched from inception dates to April 2020.We identified published randomised controlled trials(RCTs)in which the intervention involved the use of Ambu laryngeal masks and i-gel in anaesthetised paediatric patients(age<18 years).We assessed the oropharyngeal leak pressure(OLP)as the primary outcome.The secondary outcomes were insertion time,success rate of insertion on the first attempt,and incidence of adverse events.RESULTS After searching for all relevant trials published up to April 2020,data from seven RCTs with a total of 667 paediatric patients(323 and 344 participants in the i-gel and Ambu groups,respectively)were evaluated.The mean OLP in anaesthetised paediatric patients was lower in the Ambu group[21.82 cmH2O for Ambu vs 23.98 cmH2O for i-gel,P=0.003,95%confidence interval(CI):-3.58 to-0.75,I2=68%,Mantel-Haenszel random model].We did not find any clear evidence of differences between the devices in terms of insertion time,success rate of insertion,and incidence of adverse events except for blood staining(risk ratio 5.86,95%CI:1.76 to 19.46,P=0.004,I2=0,fixed-effect model).CONCLUSION The i-gel airway may provide a better seal and is therefore probably more suitable than the Ambu laryngeal mask airway in anaesthetised paediatric patients.However,the evidence is insufficient to allow making firm conclusions or to guide clinical practice,owing to the small number of relevant published studies.
文摘This paper examines the directing, acting and rehearsal process in transforming the ancient Babylonian epic Gilgamesh for the stage using performers＇ journals as a means of determining the effect of corporeal non-western styles on actors whose prior experience was almost exclusively in naturalistic and text-based theatre. The introduction of theatrical elements from multiple cultures including puppetry and the masks and techniques of Noh drama created a multi-tiered field for intercultural exchange. While Patrice Pavis＇s hourglass model for the transfer of theatrical material from a source to a target culture may hold true for productions that use linear modes of transmission, translation and incorporation of text, music, costumes and styles, its limitations make it necessary to posit alternative theories that take into account intercultural rehearsal practices, the collaboration of source and target culture and the dynamic interactions that take place through the agency of actor training in the fleshly physical theatre.
