声门上气道装置在全身麻醉下剖腹产中的作用。一篇范围广泛的文献综述,提出了在剖腹产手术中适当使用声门上气道装置的算法。

IF 4.2 2区 医学 Q1 ANESTHESIOLOGY
European Journal of Anaesthesiology Pub Date : 2024-09-01 Epub Date: 2024-06-19 DOI:10.1097/EJA.0000000000002024
Urvi Sanganee, Karen Jansen, Nuala Lucas, Marc Van de Velde
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引用次数: 0

摘要

本综述旨在评估已发表的有关使用声门上气道装置(SGA)对需要进行剖腹产手术的患者进行全身麻醉的气道管理的证据。妊娠期间的生理变化会给产妇的气道管理带来挑战。同时,由于荷尔蒙和机械方面的变化,妊娠期患者有肺吸入的风险。剖腹产产妇的标准气道管理方法是快速顺序诱导,然后进行气管插管。有证据表明,在特定患者中使用第二代 SGA 装置具有良好的耐受性和有效性。在这篇综述中,我们概述了现有的证据,并提供了一种算法,以便在使用 SGA 设备时做出基于证据的临床决策。我们在 Medline、Embase、PubMed、Emcare、Cochrane Library 和 CINAHL 中进行了在线文献检索。使用的检索词包括 "声门上气道"、"声门上气道装置"、"声门上气道管理"、"声门上导管"、"i-gel"、"喉罩"、"喉罩气道"、LMA"、"SGA"、"Proseal"、"Supreme"、"产科手术"、"产科操作"、"全身麻醉"、"剖腹产 "或 "剖腹产"、"腹产"。全文文章包括英语、荷兰语和法语。不包括病例报告和非剖腹产手术的研究。初步搜索结果为 815 条。经过筛选、删减和删除与主题无关或不符合纳入标准的出版物后,13 篇手稿被纳入我们的分析。纳入的文章共描述了 7722 例患者。大多数手稿都使用了第二代 SGA 装置。其中有 7 例插入失败,需要转为气管插管;这些病例使用的是第一代 SGA 装置。没有发生肺吸入病例,只有一例描述了胃反流。越来越多的证据表明,使用第二代 SGA 装置作为需要全身麻醉的剖腹产手术中固定气道的主要方法,对于吸入风险低和插管困难的特定患者来说,可能会有很好的耐受性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of supraglottic airway devices for caesarean section under general anaesthesia. A scoping literature review with a proposed algorithm for the appropriate use of supraglottic airway devices for caesarean sections.

This review aims to assess the published evidence on airway management with a supraglottic airway device (SGA) for general anaesthesia in patients requiring a caesarean section. Physiological changes during pregnancy can make airway management in parturients challenging. At the same time, pregnant patients are at risk of pulmonary aspiration due to hormonal and mechanical alterations. The standard airway management for parturients undergoing caesarean section is rapid sequence induction followed by tracheal intubation. Evidence exists that using second-generation SGA devices is well tolerated and effective in selected patients. In this review, we provide an overview of the existing evidence and provide an algorithm to make an evidence-based clinical decision on the use of SGA devices. An online literature search was performed in Medline, Embase, PubMed, Emcare, Cochrane Library and CINAHL. The search terms used were 'supraglottic airway', 'supraglottic airway device', 'supraglottic airway management', 'supraglottic tube', 'i-gel', laryngeal mask', 'laryngeal mask airway', 'LMA', 'SGA', 'Proseal', 'Supreme', 'obstetric surgery', 'obstetric operation', 'general anaesthesia', 'caesarean' or 'caesarean section', 'abdominal delivery'. Full-text articles in English, Dutch and French were included. Case reports and studies in which the surgery was not a caesarean section were excluded. The initial search yielded 815 results. Following screening, deduplication and removal of publications that were unrelated to the topic or did not fit the inclusion criteria, 13 manuscripts were included in our analysis. A total of 7722 patients were described in the articles included. In the majority of manuscripts, second-generation SGA devices were used. There were seven cases of failed insertion and a need for conversion to tracheal intubation; first-generation SGA devices were used in these cases. There were no cases of pulmonary aspiration, and only one case of gastric regurgitation was described. Growing evidence suggests that the use of second-generation SGA devices might be well tolerated as the primary method for securing the airway for caesarean sections requiring general anaesthesia, in selected patients with a low risk for aspiration and difficult intubation.

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来源期刊
CiteScore
6.90
自引率
11.10%
发文量
351
审稿时长
6-12 weeks
期刊介绍: The European Journal of Anaesthesiology (EJA) publishes original work of high scientific quality in the field of anaesthesiology, pain, emergency medicine and intensive care. Preference is given to experimental work or clinical observation in man, and to laboratory work of clinical relevance. The journal also publishes commissioned reviews by an authority, editorials, invited commentaries, special articles, pro and con debates, and short reports (correspondences, case reports, short reports of clinical studies).
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