|
|
喉罩在腹腔镜手术中的应用进展
|
Abstract:
喉罩作为一种声门上气道工具，因其具有操作简单、血流动力学稳定和气道并发症发生率较低等特点，已逐渐成为传统气管插管的良好替代方案。近年来，随着喉罩设计的改进与麻醉技术的发展，喉罩在外科手术中的适用范围越来越广，包括肝胆外科、妇科、泌尿外科等多种腹腔镜手术。本文将分析腹腔镜手术中应用喉罩的安全性和优势，并总结喉罩在常见腹腔镜手术中的临床应用进展。
As a supraglottic airway device, laryngeal mask airway (LMA) has gradually become a good alternative to traditional endotracheal intubation because of its simple operation, stable hemodynamics and low incidence of airway complications. In recent years, with the improvement of LMA design and the development of anesthesia technology, the application scope of LMA in surgical operation is more and more widely, including laparoscopic surgery of hepatobiliary surgery, gynecology, urology and so on. This article will analyze the safety and advantages of LMA application in laparoscopic surgery, and summarize the clinical application progress of LMA in common laparoscopic surgery.
| [1] | 王刚, 沈根海, 高泉根, 等. 腹腔镜完全腹膜外腹股沟疝修补术与开放无张力腹股沟疝修补术治疗老年腹股沟疝的临床效果[J]. 中国老年学杂志, 2018, 38(7): 1646-1648. |
| [2] | Hellberg, A., Rudberg, C., Kullman, E., Enochsson, L., Fenyö, G., Graffner, H., et al. (1999) Prospective Randomized Multicentre Study of Laparoscopic versus Open Appendicectomy. Journal of British Surgery, 86, 48-53. https://doi.org/10.1046/j.1365-2168.1999.00971.x |
| [3] | Brain, A.I.J. (1983) The Laryngeal Mask—A New Concept in Airway Management. British Journal of Anaesthesia, 55, 801-805. https://doi.org/10.1093/bja/55.8.801 |
| [4] | Doyle, M.T., Twomey, C.F., Owens, T.M. and McShane, A.J. (1998) Gastroesophageal Reflux and Tracheal Contamination during Laparoscopic Cholecystectomy and Diagnostic Gynecological Laparoscopy. Anesthesia & Analgesia, 86, 624-628. https://doi.org/10.1097/00000539-199803000-00035 |
| [5] | Cook, T.M., Woodall, N. and Frerk, C. (2011) Major Complications of Airway Management in the UK: Results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: Anaesthesia. British Journal of Anaesthesia, 106, 617-631. https://doi.org/10.1093/bja/aer058 |
| [6] | Brimacombe, J. and Keller, C. (1999) Comparison of the Flexible and Standard Laryngeal Mask Airways. Canadian Journal of Anesthesia/Journal canadien d’anesthésie, 46, 558-563. https://doi.org/10.1007/bf03013546 |
| [7] | Zhang, K. (2024) Supraglottic Airway Devices: A Powerful Strategy in Airway Management. American Journal of Cancer Research, 14, 16-32. https://doi.org/10.62347/kjru4855 |
| [8] | Yoon, S.W., Kang, H., Choi, G.J., Ryu, C., Park, Y.H., Baek, C.W., et al. (2019) Comparison of Supraglottic Airway Devices in Laparoscopic Surgeries: A Network Meta-Analysis. Journal of Clinical Anesthesia, 55, 52-66. https://doi.org/10.1016/j.jclinane.2018.12.044 |
| [9] | Bercker, S., Schmidbauer, W., Volk, T., Bogusch, G., Bubser, H.P., Hensel, M., et al. (2008) A Comparison of Seal in Seven Supraglottic Airway Devices Using a Cadaver Model of Elevated Esophageal Pressure. Anesthesia & Analgesia, 106, 445-448. https://doi.org/10.1213/ane.0b013e3181602ae1 |
| [10] | Van Zundert, A.A.J., Gatt, S.P., Van Zundert, T.C.R.V., Kumar, C.M. and Pandit, J.J. (2021) Features of New Vision-Incorporated Third-Generation Video Laryngeal Mask Airways. Journal of Clinical Monitoring and Computing, 36, 921-928. https://doi.org/10.1007/s10877-021-00780-3 |
| [11] | Brimacombe, J.R. and Berry, A. (1995) The Incidence of Aspiration Associated with the Laryngeal Mask Airway: A Meta-Analysis of Published Literature. Journal of Clinical Anesthesia, 7, 297-305. https://doi.org/10.1016/0952-8180(95)00026-e |
| [12] | Bernardini, A. and Natalini, G. (2009) Risk of Pulmonary Aspiration with Laryngeal Mask Airway and Tracheal Tube: Analysis on 65 712 Procedures with Positive Pressure Ventilation. Anaesthesia, 64, 1289-1294. https://doi.org/10.1111/j.1365-2044.2009.06140.x |
| [13] | Atkinson, T.M., Giraud, G.D., Togioka, B.M., Jones, D.B. and Cigarroa, J.E. (2017) Cardiovascular and Ventilatory Consequences of Laparoscopic Surgery. Circulation, 135, 700-710. https://doi.org/10.1161/circulationaha.116.023262 |
| [14] | Sprung, J., Abdelmalak, B. and Schoenwald, P.K. (1998) Recurrent Complete Heart Block in a Healthy Patient during Laparoscopic Electrocauterization of the Fallopian Tube. Anesthesiology, 88, 1401-1403. https://doi.org/10.1097/00000542-199805000-00035 |
| [15] | Kiely, D.G., Cargill, R.I. and Lipworth, B.J. (1996) Effects of Hypercapnia on Hemodynamic, Inotropic, Lusitropic, and Electrophysiologic Indices in Humans. Chest, 109, 1215-1221. https://doi.org/10.1378/chest.109.5.1215 |
| [16] | Zuckerman, R.S. and Heneghan, S. (2002) The Duration of Hemodynamic Depression during Laparoscopic Cholecystectomy. Surgical Endoscopy and Other Interventional Techniques, 16, 1233-1236. https://doi.org/10.1007/s00464-001-9152-0 |
| [17] | 阚红莉, 王东昕, 孙红, 等. Supreme喉罩对老年结肠癌腹腔镜手术患者血流动力学及气道阻力的影响[J]. 中国老年学杂志, 2017, 37(7): 1696-1697. |
| [18] | Akbar, A.N., Muzi, M., Lopatka, C.W. and Ebert, T.J. (1996) Neurocirculatory Responses to Intubation with Either an Endotracheal Tube or a Laryngeal Mask Airway in Humans. Journal of Clinical Anesthesia, 8, 194-197. https://doi.org/10.1016/0952-8180(95)00228-6 |
| [19] | Carron, M., Veronese, S., Gomiero, W., Foletto, M., Nitti, D., Ori, C., et al. (2012) Hemodynamic and Hormonal Stress Responses to Endotracheal Tube and ProSeal Laryngeal Mask AirwayTM for Laparoscopic Gastric Banding. Anesthesiology, 117, 309-320. https://doi.org/10.1097/aln.0b013ef31825b6a80 |
| [20] | Benedict, C.R., Shelton, B., Johnstone, D.E., Francis, G., Greenberg, B., Konstam, M., et al. (1996) Prognostic Significance of Plasma Norepinephrine in Patients with Asymptomatic Left Ventricular Dysfunction. Circulation, 94, 690-697. https://doi.org/10.1161/01.cir.94.4.690 |
| [21] | Gupta, N., Girdhar, K., Misra, A., Anand, R., Kumar, A. and Gunjan, (2010) Tube Migration during Laparoscopic Gynecological Surgery. Journal of Anaesthesiology Clinical Pharmacology, 26, 537-538. https://doi.org/10.4103/0970-9185.74605 |
| [22] | 汪伟, 吕洁, 王琦, 等. 腹腔镜手术患者SLIPA喉罩和经典型喉罩及气管插管气道管理的效果研究[J]. 中国全科医学, 2016, 19(S1): 85-88. |
| [23] | 王瑛, 王俊华, 邵强, 等. LMA-Supreme喉罩对腹腔镜胆囊切除术患者呼吸功能的影响[J]. 临床麻醉学杂志, 2013, 29(8): 794-796. |
| [24] | McHardy, F.E. and Chung, F. (1999) Postoperative Sore Throat: Cause, Prevention and Treatment. Anaesthesia, 54, 444-453. https://doi.org/10.1046/j.1365-2044.1999.00780.x |
| [25] | Kanakaraj, M., Bhat, A.D., Singh, N.P., Balasubramanian, S., Tyagi, A., Aathreya, R., et al. (2024) Choice of Supraglottic Airway Devices: A Network Meta-Analysis of Randomised Controlled Trials. British Journal of Anaesthesia, 133, 1284-1306. https://doi.org/10.1016/j.bja.2024.09.001 |
| [26] | Drake-Brockman, T.F.E., Ramgolam, A., Zhang, G., Hall, G.L. and von Ungern-Sternberg, B.S. (2017) The Effect of Endotracheal Tubes versus Laryngeal Mask Airways on Perioperative Respiratory Adverse Events in Infants: A Randomised Controlled Trial. The Lancet, 389, 701-708. https://doi.org/10.1016/s0140-6736(16)31719-6 |
| [27] | 钟剑洪, 刘妙雯, 梁江惠. 喉罩与气管插管全麻对小儿腹腔镜手术气道恢复质量影响的比较[J]. 广东医学, 2016, 37(16): 2424-2425. |
| [28] | Yang, L.Q., Zhu, L., Shi, X., Miao, C.H., Yuan, H.B., Liu, Z.Q., et al. (2023) Postoperative Pulmonary Complications in Older Patients Undergoing Elective Surgery with a Supraglottic Airway Device or Tracheal Intubation. Anaesthesia, 78, 953-962. https://doi.org/10.1111/anae.16030 |
| [29] | Griffin, R.M. and Hatcher, I.S. (1990) Aspiration Pneumonia and the Laryngeal Mask Airway. Anaesthesia, 45, 1039-1040. https://doi.org/10.1111/j.1365-2044.1990.tb14882.x |
| [30] | Lu, P.P., Brimacombe, J., Yang, C. and Shyr, M. (2002) ProSeal versus the Classic Laryngeal Mask Airway for Positive Pressure Ventilation during Laparoscopic Cholecystectomy. British Journal of Anaesthesia, 88, 824-827. https://doi.org/10.1093/bja/88.6.824 |
| [31] | Kim, D., Park, S., Kim, J.M., Choi, G.S. and Kim, G.S. (2021) Second Generation Laryngeal Mask Airway during Laparoscopic Living Liver Donor Hepatectomy: A Randomized Controlled Trial. Scientific Reports, 11, Article No. 3532. https://doi.org/10.1038/s41598-021-83173-5 |
| [32] | Maltby, J.R., Beriault, M.T., Watson, N.C., Liepert, D. and Fick, G.H. (2002) The LMA-Proseal™ Is an Effective Alternative to Tracheal Intubation for Laparoscopic Cholecystectomy. Canadian Journal of Anesthesia/Journal canadien d’anesthésie, 49, 857-862. https://doi.org/10.1007/bf03017420 |
| [33] | Nicholson, A., Cook, T.M., Smith, A.F., Lewis, S.R. and Reed, S.S. (2013) Supraglottic Airway Devices versus Tracheal Intubation for Airway Management during General Anaesthesia in Obese Patients. Cochrane Database of Systematic Reviews, No. 9, CD010105. https://doi.org/10.1002/14651858.cd010105.pub2 |
| [34] | Lemos, J., De Oliveira, G.S., de Pereira Cardoso, H.E.D., Lemos, L.D.C.N., de Carvalho, L.R. and Módolo, N.S.P. (2017) Gastric Regurgitation in Patients Undergoing Gynecological Laparoscopy with a Laryngeal Mask Airway: A Prospective Observational Study. Journal of Clinical Anesthesia, 36, 32-35. https://doi.org/10.1016/j.jclinane.2016.07.038 |
| [35] | Maltby, J.R., Beriault, M.T., Watson, N.C., Liepert, D.J. and Fick, G.H. (2003) LMA-Classic™ and LMA-ProSeal™ Are Effective Alternatives to Endotracheal Intubation for Gynecologic Laparoscopy. Canadian Journal of Anesthesia/Journal canadien d’anesthésie, 50, 71-77. https://doi.org/10.1007/bf03020191 |
| [36] | Lai, C., Liu, C., Wu, C., Tsai, F., Tseng, P. and Fan, S. (2017) I-GEL Is a Suitable Alternative to Endotracheal Tubes in the Laparoscopic Pneumoperitoneum and Trendelenburg Position. BMC Anesthesiology, 17, Article No. 3. https://doi.org/10.1186/s12871-016-0291-1 |
| [37] | Lan, S., Zhou, Y., Li, J.T., Zhao, Z.Z. and Liu, Y. (2017) Influence of Lateral Position and Pneumoperitoneum on Oropharyngeal Leak Pressure with Two Types of Laryngeal Mask Airways. Acta Anaesthesiologica Scandinavica, 61, 1114-1121. https://doi.org/10.1111/aas.12943 |
| [38] | Sun, Y., Zhang, M., Gao, X., Gao, Z., Zou, T., Guo, Y., et al. (2024) Author Correction: Effect of the New Video Laryngeal Mask Airway SaCoVLM on Airway Management in Lateral Laparoscopic Urological Surgery: A Single Center Randomized Controlled Trial. Scientific Reports, 14, Article No. 2132. https://doi.org/10.1038/s41598-024-54129-2 |
| [39] | Lee, J.E., Kim, H.Y., Lee, K.W. and Kim, G.S. (2023) Second-Generation Supraglottic Airway in Laparoscopic Donor Nephrectomy. Scientific Reports, 13, Article No. 8406. https://doi.org/10.1038/s41598-023-34691-x |
| [40] | McCaul, C.L., Harney, D., Ryan, M., Moran, C., Kavanagh, B.P. and Boylan, J.F. (2005) Airway Management in the Lateral Position: A Randomized Controlled Trial. Anesthesia & Analgesia, 101, 1221-1225. https://doi.org/10.1213/01.ane.0000171712.44746.bb |
