Role of laryngeal mask airway in laparoscopic cholecystectomy

Laparoscopic cholecystectomy is one of the most commonly performed surgical procedures and the laryngeal mask airway(LMA) is the most common supraglottic airway device used by the anesthesiologists to manage airway during general anesthesia. Use of LMA has some advantages when compared to endotracheal intubation, such as quick and ease of placement, a lesser requirement for neuromuscular blockade and a lower incidence of postoperative morbididy. However, the use of the LMA in laparoscopy is controversial, based on a concern about increased risk of regurgitation and pulmonary aspiration. The ability of these devices to provide optimal ventilation during laparoscopic procedures has been also questioned. The most important parameter to secure an adequate ventilation and oxygenation for the LMA under pneumoperitoneum condition is its seal pressure of airway. A good sealing pressure, not only state correct patient ventilation, but it reduces the potential risk of aspiration due to the better seal of airway. In addition, the LMAs incorporating a gastric access, permitting a safe anesthesia based on these commented points. We did a literature search to clarify if the use of LMA in preference to intubation provides inadequate ventilation or increase the risk of aspiration in patients undergoing laparoscopic cholecystectomy. We found evidence stating that LMA with drain channel achieves adequate ventilation for these procedures. Limited evidence was found to consider these devices completely safe against aspiration. However, we observed that the incidence of regurgitation and aspiration associated with the use of the LMA in laparoscopic surgery is very low.

General Anesthesia with Laryngeal Mask Airway: Etomidate VS Propofol for Hemodynamic Stability

Background: Propofol is the most popular induction agent for laryngeal mask airway (LMA) insertion in current anaesthesia practice however associated hypotension has been reported as its major disadvantage. Etomidate, which produces less hypotension, can be considered as an alternative agent for LMA insertion. Objectives: The objective of this study was to compare the hemodynamic effects of etomidate with propofol for induction of general anaesthesia (GA) for LMA. Ease of inserting LMA was also looked at. Material and Methods: It was a prospective randomized double blinded study. All ASA I and II patients of 15 - 60 years of age undergoing general anaesthesia with LMA for elective surgeries were included. Patients were induced with intravenous (I/V) fentanyl and induction agent either etomidate or propofol according to group randomization. LMA was inserted after 30 seconds. Intra-operative heart rate (HR), sys tolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), number of attempts and duration of LMA insertion were monitored. Results: There was no difference in the heart rate between the two groups. A significant drop was found for systolic blood pressure (SBP) in propofol group while diastolic blood pressure (DBP) was decreased in both the groups. In propofol group, successful insertion of LMA was achieved on the first attempt in 93.3% of patient as compared to 36.7% in etomidate group. Conclusion: Use of etomidate for induction of laryngeal mask anesthesia can prevent the hypotension following induction;however it may delay the insertion of laryngeal mask airway.

Total intravenous general anesthesia with laryngeal mask airway for transurethral resection of bladder tumor

Objective： To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor （TURBT）. Methods.. Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0. 75% pure bupivacaine （8-12 rag） was applied to patients in Group Ⅰ （n= 30）. Patients in Group Ⅱ （n=30） received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil ; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results ： The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ . Obturator nerve reflex was observed in 15 （50. 0%） patients in Group Ⅰ , but none （0%） in Group Ⅱ （P〈0. 01）. Conclusion.. Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.

Nursing Care of the Laryngeal Mask Airway in Pediatric Cataract Surgery

Purpose:.To investigate the important experience of nursing care of the laryngeal mask airway(LMA) in children undergoing cataract surgery.Methods: Fifty-five children undergoing cataract surgery were anesthetized by inhaling sevoflurane through a LMA and received perioperative nursing care. The safety of perioperative nursing for these children was also evaluated.Results: Through perioperative nursing care and psychological counseling for children with LMA,.all patients were anesthetized without complications and underwent successful surgeries..No severe postoperative complications were observed.Conclusion: Nursing care specific for LMA is a vital part of the success of anesthesia and pediatric cataract surgery.

Use of Laryngeal Mask Airway in the Management of a Difficult Airway: A Case Report

Background: Difficulty in management of the airway occurs most frequently in patients who have Mallampati grade III and IV, and other unfavourable airway findings like short neck, restriction in range of motion of the temporoman-dibular joints and inadequate neck flexion and extension. Because of unavailability of fibreoptic bronchoscopes or inexperience in their use, laryngeal mask airway (LMA) has become a common and acceptable airway management option. This is a case report of a postmenopausal woman who had her airway managed with LMA following initial failed intubation necessitating a rescheduling of the operation. Result: The patient had a successful surgery and postoperative recovery was uneventful. Conclusion: The LMA is a useful option in the management of an anticipated or unexpected difficult airway, especially in resource-poor settings where fibreoptic bronchoscopes may not be readily available.

Lingual nerve injury caused by laryngeal mask airway during percutaneous nephrolithotomy:A case report

BACKGROUND Lingual nerve injury(LNI)is a rare complication following the use of laryngeal mask airway(LMA).The occurrence of this unexpected complication causes uncomfortable symptoms in patients and worsens their quality of life.We present an unusual case of LNI caused by the use of an LMA in percutaneous nephrolithotomy(PCNL).CASE SUMMARY A 49-year-old man presented to our hospital with a 3-year history of intermittent left lower back pain.Abdominal computed tomography showed a 25 mm×20 mm stone in the left renal pelvis.PCNL surgery using LMA was performed to remove the renal stone.The patient reported numbness on the tip of his tongue after the operation,but there were no signs of swelling or trauma.The patient was diagnosed with LNI after other possible causes were ruled out.The symptom of numbness eventually improved after conservative medical therapy for 1 wk.The patient completely recovered 3 wk after surgery.CONCLUSION This is the first case report describing LNI with the use of LMA in PCNL.In our case,an inappropriate LMA size,intraoperative movement,and a specific surgical position might be potential causes of this rare complication.

Comparison of Postoperative Throat and Neck Complaints after the Use of the i-Gel versus the Traditional Laryngeal Mask

Introduction: One of the most important jobs of an anesthesiology is to preserve an adequate gaseous exchange. With the coming in the 80’s of the laryngeal mask airway, a less invasive technique was introduced for this end. There are a lot of variants of these supraglotic issues, being the i-gel a no inflate mask;witch principle is to provide a perilaryngel stamp that reduced the incidence of sore throat, cervical pain compared with the traditional laryngeal mask. Method: A group of 121 ASA I-II patients with general anesthesia administration, where divided in two groups, one of 60 patients where a traditional laryngeal mask airway was used, and a second group of 61 patients where an i-gel mask was used. In both groups the presence of postoperative sore throat, cervical pain and dysphonia;number of attempts and pressure in the airway tract was measured. Results: The group of patients where the i-gel was used present lower incidence of sore throat (11% vs 27%) and cervical pain (3% vs 9%) and lower values of pressure on the airway tract compared with the group in which the conventional laryngeal mask was used. On the other hand there was no difference in the presence of dysphonia, trauma or number of attempts used to insert the mask. Conclusions: The i-gel larygeal mask demonstrated to be a safe issue, with low incidence of morbidity to administrated general anesthesia.

Severe gastric insufflation and consequent atelectasis caused by gas leakage using AIR-Q laryngeal mask airway:A case report

BACKGROUND The airways of patients undergoing awake craniotomy(AC)are considered“predicted difficult airways”,inclined to be managed with supraglottic airway devices(SADs)to lower the risk of coughing or gagging.However,the special requirements of AC in the head and neck position may deteriorate SADs’seal performance,which increases the risks of ventilation failure,severe gastric insufflation,regurgitation,and aspiration.CASE SUMMARY A 41-year-old man scheduled for AC with the asleep–awake–asleep approach was anesthetized and ventilated with a size 3.5 AIR-Q intubating laryngeal mask airway(LMA).Air leak was noticed with adequate ventilation after head rotation for allowing scalp blockage.Twenty-five minutes later,the LMA was replaced by an endotracheal tube because of a change in the surgical plan.After surgery,the patient consistently showed low tidal volume and was diagnosed with gastric insufflation and atelectasis using computed tomography.CONCLUSION This case highlights head rotation may cause gas leakage,severe gastric insufflation,and consequent atelectasis during ventilation with an AIR-Q intubating laryngeal airway.

Comparison of the clinical performance of i-gel and Ambu laryngeal masks in anaesthetised paediatric patients:A meta-analysis

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.

Effect of different types of laryngeal mask airway placement on the right internal jugular vein: A prospective randomized controlled trial

BACKGROUND In recent years, with the popularity of laryngeal mask airway(LMA) for the management of clinical anesthesia, the influence of the LMA on the position and blood flow of the internal jugular vein(IJV) has attracted an increasing amount of attention.AIM To investigate the effect of placement of different types of LMA(Supreme LMA,Guardian LMA, I-gel LMA) on the position and blood flow of the right IJV.METHODS This was a prospective randomized controlled trial. A total of 102 patients aged 18-75 years who were scheduled to undergo laparoscopic abdominal surgery with general anesthesia were randomly assigned to three groups: Supreme LMA(group 1), Guardian LMA(group 2), and I-gel LMA(group 3) groups. The main indicator was the overlap index(OI) of IJV and the common carotid artery(CCA)at the high, middle, and low points before and after the placement of the LMA.The second indicators were the proportion of ultrasound-simulated needle crossing the IJV and CCA, and the cross-sectional area and blood flow velocity of the IJV before and after placement of the LMA at the middle point.RESULTS Data from 100 patients were included in the statistical analysis. The OI increased significantly after placement of the LMA in the three groups at the three points(P< 0.01), except group 2 at the low point. In group 2 and group 3, the OI was lower than that in group 1 after LMA insertion at the high point(P < 0.0167). At the middle point, after LMA insertion, the proportion of simulated needle crossing the IJV significantly decreased in all three groups(P < 0.05), and the proportion in group 2 was higher than that in group 3(P < 0.0167). The proportion of simulated needle crossing the CCA or both the IJV and CCA significantly increased in group 1 and group 2(P < 0.05), which increased with no statistical significance in group 3. After LMA insertion, the cross-sectional area of the IJV significantly increased, while the blood flow velocity significantly decreased(P <0.01). There was no significant difference among the three groups.CONCLUSION The placement of Supreme, Guardian, and I-gel LMA can increase the OI, reduce the success rate of IJV puncture, increase the incidence of arterial puncture, and cause congestion of IJV. Type of LMA did not influence the difficulty of IJV puncture. Therefore when LMA is used, ultrasound is recommended to guide the IJV puncture.

The effect of different inflation volumes of laryngeal mask airway on efficacy of closed circuit controlled ventilation in pediatric cancer patients

Objective： The laryngeal mask airway （LMA） is an established way for airway control during spontaneous ventila- tion. Its ability to deliver positive pressure ventilation without leakage especially in low flow states is still controversy. The aim of this study is to test the possibility of using LMA in pediatric closed circuit controlled ventilation, and to find out the optimum cuff volume to perform closed system ventilation. Methods： Twenty children scheduled for elective surgeries were enrolled in a crossover study. Laryngeal mask airway was used. In stage I, the cuff was inflated with the maximum volume of air as rec- ommended by the manufacturers. Adjustment of volume of air inflated into the LMA cuff to the minimum volume to obtain the effective seal was done at stage II. The leak pressure, intracuff pressure and the leak volume were measured in both stages. Results： The cuff filling volume was significantly lower compared to the maximum cuff inflation volume in stage I. Leakage values showed significantly less values in stage II of the study with smaller cuff inflation volumes. The airway leakage pressure was significantly lower in stage fl in comparison to stage I. Cuff inflation pressure in stage I showed marked elevation which dropped significantly after adjustment of cuff volume in stage I1. Conclusion： Laryngeal mask airway is an effective tool to provide closed circuit controlled ventilation in pediatrics. Inflation of the cuff by the minimum volume of air needed to reach the just sealing pressure is suggested to minimize the leakage volume.

Clinical Observation of Double Tube Laryngeal Mask in Fast-Track Anesthesia for Limb Orthopedic Surgery in Children with Cerebral Palsy

Objective: To compare and analyze the effect and safety of double tube laryngeal mask and endotracheal intubation general anesthesia in fast track anesthesia for limb orthopaedic surgery in children with cerebral palsy. Methods: 78 children with cerebral palsy undergoing limb orthopedic surgery were randomly divided into laryngeal mask group and intubation group, with 39 cases in each group. The perioperative hemodynamic indexes, anesthesia effect related indexes, anesthesia related complications or adverse reaction rates of the two groups were observed and compared between the two groups. Results: When the two groups of children entered the room, there was no significant difference in MAP and HR (P > 0.05);MAP and HR of children in the intubation group were higher than those in the laryngeal mask anesthesia group (P Conclusion: Laryngeal mask is used to establish the airway of intravenous general anesthesia in limb orthopaedic surgery of children with cerebral palsy, which is conducive to the stability of children’s circulatory and respiratory system, to reduce the impact of narcotic drugs on children, to reduce the incidence of postoperative anesthesia related complications, and to improve the anesthetic effect. It meets the requirements of fast track anesthesia, and can be widely used in clinical practice.

Study on Effect of Laryngeal Mask Anesthesia and Endotracheal Intubation Anesthesia on Elderly Patients Undergoing Laparoscopic Gallbladder Surgery

Objective:To analyze the effect of laryngeal mask anesthesia and endotracheal intubation anesthesia in elderly laparoscopic gallbladder surgery.Methods:100 subjects of the experiment came from elderly patients with gallbladder stones admitted from September 2016 to September 2019 in our hospital.There were group A and group B of 50 cases each,and were used tube anesthesia and laryngeal mask anesthesia,then comparing the anesthesia effect.Results:Statistical significance(P<0.05):Air pressure and end-respiratory carbon dioxide partial pressure index changes when immediately after insertion,immediately after removal,3 minutes after removal;heart rate,mean arterial pressure,airway pressure,and end-expiratory carbon dioxide index changes when 3 minutes after insertion and immediately before removal;blood glucose and cortisol changes when after insertion,immediately before removal and min after removal.No statistical significance(P>0.05):Changes in heart rate,mean arterial pressure,airway pressure,and endexpiratory carbon dioxide indexes before insertion;changes in blood glucose and cortisol indexes before insertion.Conclusion:It is more ideal for elderly patients with abdominal cavity and gallbladder surgery to have laryngeal mask anesthesia,which can effectively keep blood circulation stable and have promotion value.

Assessment of Laryngeal Mask Airway in General Anesthesia during Thyroidectomy without Applying Miorelaxants

The selective approach of anesthesia has a crucial role in the surgical treatment of thyroid diseases.Anesthesia during the insertion of a laryngeal mask airway is an alternative instead of endotracheal tube,hence this is a novel period in anesthesiology.

Shikani Optical Stylet–guided Intubation via the Intubating Laryngeal Airway in Patients With Scar Contracture of the Face and Neck

Objective To evaluate the feasibility of the Shikani Optical Stylet （SOS）-guided inmbation through a new Intubafing Laryngeal Airway （ILA） in anticipated difficult airways caused by scar contracture of the face and neck. Methods Thirty-three adult patients with anticipated difficult airways undergoing selective faciocervical scar plastic surgery under general anesthesia were enrolled in this study. After anesthesia induction, a size 2.5, 3.5 or 4.5 ILA was inserted. Following good lung ventilation being verified, the SOS preloaded with an endotracheal tube was inserted via the ILA. Once the clear vocal cords came into view under the SOS, the endotracheal tube was advanced through glottis into the trachea. Results The ILA provided an effective airway in all patients, lntubation was successful at the first attempt on 22/33 （66.7%） occasions and at the second attempt on 6/33 （18.2%）. Intubation failed in 5 （15.1%） patients who suffered from severe limitation of head extension due to scar contracture of the neck. These patients＇ tracheas were finally intubated using a fibreoptic bronchoscope via the ILA. Conclusions The SOS-guided intubating method via the ILA is a feasible technique in patients with scar contracture of the face and neck. However, in patients with severe limitation of head extension, the use of SOS cannot be recommended. The SOS can be used as an alternative apparatus when the fibreoptic bronchoscope is not available.

无肌松联合胃镜喉罩在肝硬化患者内镜静脉曲张套扎术中的应用

目的评价无肌松联合胃镜喉罩在肝硬化患者内镜静脉曲张套扎术(EVL)中的应用效果。方法选取2021年12月至2022年8月于郑州大学第一附属医院接受择期EVL的肝硬化患者80例,采用随机数字表法分为对照组(40例)和观察组(40例)。两组均接受胃镜喉罩通气,其中对照组接受肌松药常规静脉诱导。记录喉罩置入成功情况、套扎器置入成功情况和置入时间;记录术中低血压、心动过缓、低氧血症的发生情况;记录喉罩放置到位后1 min、套扎器置入食管入口即刻和术毕即刻的气道峰压和气道密封压;记录拔管时间、麻醉恢复室(PACU)停留时间;记录术后6 h内咽痛和恶心呕吐及乏力发生情况;记录术后内镜医师及患者的满意度评分。结果两组喉罩置入成功率、套扎器置入成功率、术中低血压、心动过缓、术后6 h内咽痛和恶心呕吐发生率、内镜医生满意度评分比较,差异无统计学意义(P>0.05)。两组气道峰压时间效应、气道密封压组间效应、时间效应有统计学意义(P<0.05)。观察组拔管时间、PACU停留时间缩短,乏力发生率低,患者满意度高(P<0.05)。两组术中均未见低氧血症发生。结论无肌松联合胃镜喉罩用于内镜EVL肝硬化患者具有拔管早、乏力发生率低、患者满意度高等优势。

帝视观察用内窥镜辅助喉罩置入的临床效果

目的探讨帝视观察用内窥镜引导喉罩置入的效果,为临床麻醉气道管理提供依据。方法选择2022年3月至2024年3月在揭阳市人民医院行喉罩置入全身麻醉患者60例,采用随机数字表将纳入研究患者分为观察组和对照组,每组30例。观察组使用帝视观察用内窥镜辅助喉罩置入,对照组使用传统徒手喉罩置入法。记录两组患者喉罩置入成功总时间(喉罩进入口腔到判定喉罩置入成功)、喉罩首次置入成功率、气道峰压、口咽漏气压以及喉罩置入损伤并发症发生情况,包括麻醉恢复室拔除喉罩后喉罩表面有无血迹、术后24 h内咽痛发生率。结果与对照组比较,观察组喉罩置入成功总时间明显缩短(P<0.001),喉罩首次置入成功率明显升高(P<0.05),两组喉罩型号比较差异无统计学意义(P>0.05);与对照组比较,观察组气道峰压明显降低(P<0.001),口咽漏气压明显升高(P<0.001);两组喉罩表面有血迹、术后24 h内咽痛发生率比较差异无统计学意义(P>0.05)。结论帝视观察用内窥镜引导喉罩置入,可以提高喉罩首次置入成功率,缩短喉罩置入成功总时间,降低气道峰压,升高口咽漏气压,有较高安全性,值得推广。

单孔胸腔镜下保留自主呼吸喉罩麻醉在肺结节楔形切除术中的应用

目的探究行单孔胸腔镜下肺结节切除患者采用保留自主呼吸喉罩麻醉的效果。方法随机选取2022年1月—2023年10月在厦门大学附属第一医院行单孔胸腔镜肺结节切除术的60例患者为研究对象,采用随机数表法分为两组,每组30例。对照组采用双腔支气管插管麻醉,观察组采用保留自主呼吸喉罩麻醉。对比两组麻醉前后的心率及平均动脉压、麻醉复苏时间、麻醉药物用量、麻醉相关并发症发生情况。结果麻醉后,观察组心率、平均动脉压高于对照组,差异有统计学意义(P均<0.05)。观察组麻醉复苏时间更短,且麻醉药物用量更少,差异有统计学意义(P均<0.05)。观察组麻醉相关并发症发生率为10.00%,低于对照组的33.33%,差异有统计学意义(χ^(2)=4.811,P<0.05)。结论行单孔胸腔镜肺结节切除术时选用保留自主呼吸喉罩麻醉能够使患者术中生命体征更加稳定,减少麻醉药物使用量,缩短麻醉苏醒时间,降低麻醉相关并发症发生率。

喉罩全身麻醉联合“圈麻”阻滞用于结肠癌手术的麻醉效果

目的 观察喉罩全身麻醉联合腹部“圈麻”阻滞用于腹腔镜下结肠癌切除手术的麻醉效果。方法 选取2022年1月至2023年3月于厦门市第三医院行腹腔镜下结肠癌切除手术的患者60例,根据随机数字表法将其分为L组(喉罩全身麻醉,30例)和U组(喉罩全身麻醉联合腹部“圈麻”阻滞,30例)。记录并比较两组患者麻醉维持的丙泊酚和瑞芬太尼用量、手术完成时间、意识清醒后视觉模拟评分法(visual analogue scale,VAS)评分和舒芬太尼用量。比较两组患者术后12h的镇痛满意度。结果 两组患者的性别、年龄、体质量、身高、手术时间比较差异均无统计学意义(P>0.05)。U组患者的瑞芬太尼和丙泊酚总用量均显著少于L组(P<0.001);U组患者麻醉恢复室内的VAS评分显著低于L组,舒芬太尼用量显著少于L组(P<0.001)。U组患者的镇痛满意度显著高于L组(χ^(2)=6.772,P=0.031)。结论 与单一喉罩全身麻醉相比,喉罩全身麻醉联合腹部“圈麻”阻滞可减少腹腔镜下结肠癌切除手术中麻醉维持药物和麻醉恢复室内舒芬太尼的用量,改善术后镇痛满意度。

减小喉罩型号改善通气效果的临床观察

目的探讨减小喉罩型号改善通气效果的临床观察。方法选取喉罩固定翼距门齿距离>3 cm的男性患者60例为研究对象,随机分为试验组和对照组,每组30例。比较试验组(3号喉罩)与对照组(4号喉罩)的通气优良率、FOB理想位置比例、气道峰压差及2组喉罩置入后的密封压、套囊内压、漏气率,比较2组喉罩远端与食道入口距离,观察2组喉罩拔出时带血丝情况,术后24 h咽部并发症发生情况(包括术后咽痛、声嘶)及咽痛持续时间。2组患者设置的呼吸参数相同。结果试验组喉罩置入后通气成功率、FOB理想位置置入比例及通气效果优良率提高,漏气率值降低,密封压值提高,喉罩远端距食道入口距离较对照组减小,术后咽部并发症发生率较对照组低,差异均有统计学意义(P<0.05)。结论对于喉罩固定翼距门齿距离>3 cm的患者,通过减小喉罩型号,使喉罩放置理想位置比例增加,通气优良率升高,漏气率降低,密封压值提高,咽部并发症降低,可改善喉罩通气效果,安全有效。