喉罩与气管内插管在小儿腹腔镜腹股沟疝修补术中的应用：一项随机对照试验。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery Pub Date : 2025-05-15 DOI:10.1016/j.jpedsurg.2025.162367

Emily L. Weisberg , Benjamin J. Pieters , Meredith S. Elman , Cory J. Nonnemacher , Janelle Noel-MacDonnell , Tolulope A. Oyetunji

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引用次数: 0

摘要

背景：喉罩气道（LMA）通常用于许多类型的儿科外科手术，并作为一种救援气道装置。腹腔镜手术在儿科手术中很常见，并且正变得越来越普遍。在腹腔镜手术中，传统的气道入路是采用气管内插管，而LMA在腹腔镜手术中的应用研究较少。目的：评价LMA全麻与传统气管插管（ETT）在12个月~ 8岁儿童腹腔镜腹股沟疝修补术中的效果。方法：在一项单机构前瞻性随机试验中，于2023年4月至2024年5月招募了接受腹腔镜腹股沟疝修补术的儿科患者。患者随机接受LMA或ETT全麻。主要终点是在三个标准化时间点测量的血氧饱和度（SpO2）百分比。次要终点是相同三个标准化时间点的末潮二氧化碳（EtCO2）水平和气道峰值压力（PAP）测量，以及每组记录的任何喉痉挛或去饱和发作的发生。结果：腹腔镜腹股沟疝全麻手术50例，LMA 25例，ETT 25例。两组间氧合无临床显著差异。此外，两组间EtCO2水平无统计学差异。与LMA患者相比，ETT患者在所有三个时间点的气道压力峰值均较高。在每个研究组中均有一例血饱和度降低，没有喉痉挛发作。结论：在适当的儿科患者中，短时间腹腔镜手术中使用LMA是一种安全有效的替代ETT的方法。临床试验注册：该研究已在ClinicalTrials.gov注册NCT06023394。临床意义：LMA在儿科手术中的使用是常见的。美国评估LMA在儿童腹腔镜手术中的疗效的数据有限，没有研究，本研究旨在增加前瞻性数据。

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查看原文本刊更多论文

The Use of Laryngeal Mask Airway Versus Endotracheal Intubation in Pediatric Laparoscopic Inguinal Hernia Repair: A Randomized Controlled Trial

Background

A laryngeal mask airway (LMA) is routinely used for many types of pediatric surgical procedures and as a rescue airway device. Laparoscopic procedures in pediatric surgery are common and are becoming increasingly widespread. In laparoscopic surgery, the traditional airway approach is the use of endotracheal intubation, while the use of LMA in laparoscopic surgery is not well studied.

Aims

To evaluate the effectiveness of general anesthesia with LMA versus traditional endotracheal tube (ETT) for pediatric patients aged 12 months to 8 years old undergoing laparoscopic inguinal hernia repair.

Methods

In a single institution prospective randomized trial, pediatric patients undergoing laparoscopic inguinal hernia repair were recruited from April 2023 to May 2024. Patients were randomized to general anesthesia with either an LMA or ETT. The primary endpoint was oxygen saturation in percent saturation (SpO₂) measured at three standardized timepoints. Secondary endpoints were end tidal carbon dioxide (EtCO₂) levels and peak airway pressure (PAP) measurements at the same three standardized timepoints as well as the occurrence of any episodes of laryngospasm or desaturation documented in each group.

Results

Fifty patients underwent laparoscopic inguinal hernia surgery with general anesthesia, twenty-five patients with LMA and twenty-five with ETT. There was no clinically significant difference in oxygenation between study groups. Additionally, there was no statistically significant difference between study arms in EtCO₂ levels. Patients with ETT had higher peak airway pressures compared to patients with LMA at all three time points. There was one incident of desaturation in each study arm and no episodes of laryngospasm.

Conclusions

The use of LMA in short laparoscopic surgery is a safe and effective alternative to ETT in appropriate pediatric patients.

Level of Evidence

1b.

Clinical Trial Registration

This study is registered with ClinicalTrials.gov NCT06023394.

Clinical Implications

The use of LMA in pediatric surgery is common. There is limited data and no studies from the United States assessing the efficacy of LMA in pediatric laparoscopic surgery and this study aims to add prospective data.

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来源期刊

Journal of pediatric surgery 医学-外科

CiteScore

1.10

自引率

12.50%

发文量

569

审稿时长

38 days

期刊介绍： The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.