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sábado, 11 de marzo de 2017

ML en niños obesos / LMA in obese children

Marzo 3, 2017. No. 2617

Un ensayo clínico que evalúa la máscara laríngea de la vía aérea-Supreme en niños obesos durante la anestesia general

A clinical trial evaluating the laryngeal mask airway-Supreme in obese children during general anesthesia.

Tian Y1, Wu XY1, Li L1, Ma L1, Li YF1.

Arch Med Sci. 2017 Feb 1;13(1):183-190. doi: 10.5114/aoms.2017.64719. Epub 2016 Dec 19.

Abstract

INTRODUCTION: The laryngeal mask airway (LMA)-Supreme is a disposable double-lumen laryngeal mask airway that is widely used in clinical practice. However, its use in obese children has not been evaluated. The aim of this study was to determine whether the LMA-Supreme could perform equally as well as endotracheal intubation in obese children having a minor surgical procedure. MATERIAL AND METHODS: After ethical board approval, 100 obese male children receiving non-emergent appendectomy for chronic appendicitis or surgery to correct concealed penis were randomly divided into an endotracheal intubation group and an LMA-Supreme group. Endotracheal intubation was performed under direct vision laryngoscopy. In the LMA group, a size-3 LMA-Supreme was placed and a stomach tube inserted via the drainage tube of the mask. Cardiovascular and respiratory parameters, time taken for placement, placement attempts, time to removal of the endotracheal tube/LMA, length of stay in the post-anesthesia care unit (PACU), and complications were recorded. RESULTS: Insertion time was significantly longer (p < 0.001) in the LMA-Supreme group than in the endotracheal intubation group. Peak airway pressure was significantly higher, and pulmonary compliance and PACU stay time lower in the LMA-Supreme group. No significant differences between endotracheal intubation and the LMA-Supreme were seen in other parameters, except for a higher incidence of coughing in the endotracheal intubation group. CONCLUSIONS: The LMA-Supreme can be easily inserted and effectively used for airway management in obese children undergoing minor surgery.

KEYWORDS: airway sealing pressure; laryngeal mask airway; obese children; peripheral oxygen saturation; ventilation

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