在家兔中使用声门上装置是否比其他气道管理装置造成的伤害更小?

Jasmine Gheini, S. Zaki
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摘要

在接受全身麻醉的兔子中,与使用其他气道管理设备相比,放置v-gel®设备是否导致更少的气道创伤?临床结论研究问题类别治疗方法研究设计的数量和类型综述了三篇论文进行了严格评价,两项随机盲法试验研究和一项随机交叉试验研究证据强度弱结果报告一项随机盲法试验研究表明,使用v-gel®和气管内插管对兔麻醉期间上呼吸道的创伤没有显著差异。另一项盲法随机试验研究表明,气管内插管对上呼吸道造成的创伤明显大于v-gel®置入造成的创伤。随机交叉试验研究表明,与喉罩或面罩相比,v-gel®对喉部的压迫更明显。结论:目前的证据表明,与放置气管内管相比,在家兔中使用v-gel®对气道的创伤/损伤更小,但与使用喉罩或面罩相比则没有。然而,基于已发表研究的数量和质量,这一证据是薄弱的,需要更高质量的研究来支持在家兔中常规使用v-gel®而不是其他气道设备。虽然与气管插管相比,v-gel®可能是一种更安全的方法来保护家兔的气道,但了解该装置可能对上呼吸道造成的损伤对于麻醉后恢复过程中家兔的管理是有用的。如何在实践中应用该证据?个人的临床专业知识,病人的情况和业主的价值观,你工作的国家,地点或诊所,你面前的个案,治疗和资源的可用性。知识摘要是帮助加强或告知决策的资源。他们不会凌驾于从业者的责任或判断之上,去做对他们照顾的动物最好的事情。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Does the use of supraglottic device in rabbits cause less injury than other airway management devices?
PICO question In rabbits, undergoing general anaesthesia, does the placement of a v-gel® device result in less airway trauma compared to the use of other airway management devices?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Three papers were critically appraised, two blinded randomised experimental trial studies and one randomised crossover experimental trial study Strength of evidence Weak Outcomes reported One blinded randomised trial study demonstrated that the trauma to the upper airways of rabbits during anaesthesia is not significantly different between the use of v-gel® and an endotracheal tube. The other blinded randomised trial study demonstrated that the trauma to the upper airway caused by endotracheal intubation is significantly more than that caused by v-gel® placement. The randomised crossover trial study demonstrated that v-gel® placement causes more significant compression to the larynx compared to a laryngeal mask or face mask Conclusion The current evidence suggests that use of the v-gel® in rabbits causes less trauma / injury to the airways compared to placement of an endotracheal tube but not compared to the use of a laryngeal or face mask. However, based on the low number and quality of published studies, this evidence is weak, and better-quality studies are required to support the routine use of v-gel® over other airway devices in rabbits. While v-gel® may be a safer alternative for securing airways in rabbits compared to endotracheal intubation, knowing the injuries this device can cause to the upper airways is useful for managing rabbits during post anaesthesia recovery   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
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