Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjan.2012.08.002
Brazilian Journal of Anesthesiology
Scientific Article

Comparação de via aérea por máscara laríngea Supreme e via aérea por máscara laríngea ProSeal para trauma laringofaríngeo e morbidade pós-operatória em crianças

Comparison of laryngeal mask airway supreme and laryngeal mask airway proseal for laryngopharyngeal trauma and postoperative morbidity in children

Meltem Turkay Aydogmus; Birsen Eksı; oglu; Sibel Oba; Oya Ünsal; Hacer Sebnem Yeltepe Türk; Sı; tkı; Nadir Sı; nı; koglu; Aslı; han Tug

http://dx.doi.org/10.1016/j.bjan.2012.08.002 Braz J Anesthesiol, vol.63, n6, p.445-449, 2013
PDF Português
PDF English
Downloads: 0
Views: 924

Resumo

EXPERIÊNCIA E OBJETIVOS: A via aérea por máscara laríngea (LMA), que tem sido utilizada frequentemente no tratamento das vias aéreas, pode causar lesão e morbidade na área laringofaríngea. Nesse estudo, comparamos as alterações macroscópicas nas estruturas laringofaríngeas e a morbidade laringofaríngea pós-operatória pelo uso da LMA Supreme® versus LMA ProSeal® em crianças. MÉTODOS: Dividimos os pacientes em dois grupos. Inserimos LMA ProSeal #3 no primeiro grupo e LMA Supreme #3 no segundo grupo. Antes da inserção da LMA e em seguida à sua remoção, fizemos laringoscopia direta nos pacientes. Comparamos entre os dois grupos: hiperemia, lesão de mucosa e as manchas de sangue por ocasião da remoção da LMA, e também o tempo de inserção, percentual de sucesso na inserção do tubo gástrico na primeira tentativa, náusea, vômito e dor de garganta. RESULTADOS: Não foram observadas diferenças significativas entre os dois grupos para tempo médio de operação, gênero, idade, peso, percentual de sucesso na inserção do tubo gástrico na primeira tentativa, náusea, vômito, dor de garganta e lesão de mucosa. O tempo médio de inserção para o grupo LMA ProSeal foi significativamente maior versus grupo LMA Supreme (p = 0,0001). O índice de manchas de sangue na remoção da LMA foi significativamente mais alto no grupo LMA ProSeal versus LMA Supreme (p = 0,034). Os pacientes que apresentaram manchas de sangue por ocasião da remoção da LMA exibiram hiperemia e lesão de mucosa significativamente mais expressivas versus pacientes com LMA limpa (p = 0,0001, p = 0,020). CONCLUSÃO: Em crianças, a inserção da LMA Supreme é mais rápida e fácil do que a inserção da LMA ProSeal; e, em comparação com LMA ProSeal, causa menos lesão laringofaríngea.

Palavras-chave

Via aérea por máscara laríngea Supreme, Via aérea por máscara laríngea ProSeal

Abstract

BACKGROUND AND OBJECTIVES: Laryngeal mask airway (LMA), which has been used frequently in airway management, can cause laryngopharyngeal injury and morbidity. In this trial, we compare the macroscopic changes on laryngopharyngeal structures and the postoperative laryngopharyngeal morbidity by using LMA supreme with LMA proseal in children. METHODS: We divided patients into two groups. We inserted size three LMA proseal into the first group and size three LMA supreme into the second group. Before LMA insertion and after LMA removal, we performed direct laryngoscopy on the patients. We compared hyperemia, mucosal injury and blood staining on LMA removal, as well as insertion time, rate of success in gastric tube insertion on the first attempt, nausea, vomiting, and sore throat between the two groups. RESULTS: We recorded no significant differences between the two groups for mean operation time, sex, age, weight, rate of success in gastric tube insertion on first attempt, nausea, vomiting, sore throat and mucosal injury. Mean insertion time for the LMA proseal group was significantly longer than the LMA supreme group (p = 0.0001). The ratio of blood staining on LMA removal was significantly higher in the LMA proseal group than the LMA supreme group (p = 0.034). The patients with blood staining on LMA removal exhibited significantly more mucosal hyperemia and injury than the patients with clear LMA (p = 0.0001, p = 0.020). CONCLUSION: LMA supreme insertion is faster and easier than LMA proseal and causes less laryngopharyngeal injury than LMA proseal in children.

Keywords

Laryngeal mask airway supreme, Laryngeal mask airway proseal

References

Singh M, Bharti R, Kapoor D. Repair of damaged supraglottic airway devices: A novel method. Scand J Trauma Resusc Emerg Med. 2010;17:18-33.

Sharma V, Verghese C, McKenna PJ. Prospective audit on the use of the LMA-Supreme for airway management of adult patients undergoing elective orthopaedic surgery in prone position. Br J Anaesth. 2010;105:228-32.

Ali A, Canturk S, Turkmen A. Comparison of the laryngeal mask airway Supreme and laryngeal mask airway Classic in adults. Eur J Anaesthesiol. 2009;26:1010-4.

Verghese C, Ramaswamy B. LMA-Supreme-a new single-use LMA with gastric access: a report on its clinical efficacy. Br J Anaesth. 2008;101:405-10.

Seet E, Rajeev S, Firoz T. Safety and efficacy of laryngeal mask airway Supreme versus laryngeal mask airway ProSeal: a randomized controlled trial. Eur J Anaesthesiol. 2010;27:602-7.

Tekin M, Kati I, Tomak Y. Comparison of the effects of room air and N2O + O2 used for ProSeal LMA cuff inflation on cuff pressure and oropharyngeal structure. J Anesth. 2008;22:467-70.

Martins RH, Braz JR, Defaveri J. Effect of high laryngeal mask airway intracuff pressure on the laryngopharyngeal mucosa of dogs. Laryngoscope. 2000;110:645-50.

Seet E, Yousaf F, Gupta S. Use of manometry for laryngeal mask airway reduces postoperative pharyngolaryngeal adverse events: a prospective, randomized trial. Anesthesiology. 2010;112:652-7.

Brimacombe J, Richardson C, Keller C. Mechanical closure of the vocal cords with the laryngeal mask airway ProSeal. Br J Anaesth. 2002;88:296-7.

Chia YY, Lee SW, Liu K. Propofol causes less postoperative pharyngeal morbidity than thiopental after the use of a laryngeal mask airway. Anesth Analg. 2008;106:123-6.

Grady DM, McHardy F, Wong J. Pharyngolaryngeal morbidity with the laryngeal mask airway in spontaneously breathing patients: does size matter?. Anesthesiology. 2001;94:760-6.

Timmermann A, Cremer S, Eich C. Prospective clinical and fiberoptic evaluation of the Supreme laryngeal mask airway. Anesthesiology. 2009;110:262-5.

Timmermann A, Cremer S, Heuer J. Laryngeal mask LMA Supreme: Application by medical personnel inexperienced in airway management. Anaesthesist. 2008;57:970-5.

Tan BH, Chen EG, Liu EH. An evaluation of the laryngeal mask airway supreme in 100 patients. Anaesth Intensive Care. 2010;38:550-4.

Jagannathan N, Sohn LE, Sawardaker A. A randomised comparison of the LMA SupremeTM and LMA ProSealTM in children. Anaesthesia. 2012;67:632-9.

Eschertzhuber S, Brimacombe J, Hohlrieder M. The laryngeal mask airway Supreme-a single use laryngeal mask airway with an oesophageal vent: A randomised, crossover study with the laryngeal mask airway ProSeal in paralysed, anaesthetised patients. Anaesthesia. 2009;64:79-83.

5dd3eea90e8825a159c63493 rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections