经典喉罩与气管插管在俯卧位短时泌尿外科手术气道管理中的比较：一项随机对照试验
Comparison of Classic Laryngeal Mask Airway and Endotracheal Intubation for Airway Management During Short Urologic Procedures in the Prone Position: A Randomized Controlled Trial.
文献信息
| PMID | 42928882 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Naeimeh Naeimi Bafghi |
| 作者单位 | Clinical Research Center Shahid Bahonar Hospital Kerman University of Medical Sciences Kerman Iran kmu.ac.ir. |
| 期刊 | Anesthesiology research and practice |
| SCI 分区 | Q3 |
| IF | 2 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 俯卧位的气道管理仍是麻醉中的一大挑战，尤其是在短时泌尿外科手术期间。尽管气管插管（ETT）被视为标准技术，但经典喉罩（LMA）已成为无预期困难气道患者的一种创伤更小的替代方案。本研究旨在比较经典LMA与ETT在俯卧位泌尿外科手术气道管理中的有效性和安全性。
方法： 在这项随机临床试验中，70例接受俯卧位泌尿外科手术且手术时间≤90分钟的患者被分配至经典LMA组或ETT组（每组n=35）。主要结局包括通过峰值气道压（Ppeak）评估的术中通气性能、气道技术转换的需求以及气道相关并发症。次要结局包括术中血流动力学和呼吸参数，包括心率（HR）、收缩压和舒张压（SBP/DBP）、血氧饱和度（SpO2）、呼气末二氧化碳（ETCO2）、Ppeak、分钟通气量（VE）以及术后并发症。
结果： 两组基线人口学和围手术期特征具有可比性。经典LMA组与ETT组在术中血流动力学变量、SpO2、ETCO2或VE方面未观察到显著差异。ETT组的Ppeak显著更高（p < 0.001）。在恢复期间，两组均观察到血流动力学和呼吸参数随时间相关的变化，但未发现具有临床意义的组间差异。术后并发症，包括咽喉痛和喉痉挛，不常见且两组间相当。
结论： 在短时俯卧位泌尿外科手术中，经典LMA提供了与ETT相当的气道维持和通气，对于符合适当气道评估标准的患者，可考虑将其作为一种可行的气道装置。试验注册：伊朗临床试验注册中心（IRCT）：IRCT20250729066688N1。
英文摘要
BACKGROUND: Airway management in the prone position remains a major challenge in anesthesia, particularly during short urologic procedures. Although endotracheal intubation (ETT) is considered the standard technique, the Classic laryngeal mask airway (LMA) has emerged as a less invasive alternative in patients without an anticipated difficult airway. This study aimed to compare the efficacy and safety of Classic LMA versus ETT for airway management in prone-position urologic surgeries.
METHODS: In this randomized clinical trial, 70 patients undergoing prone-position urologic surgery with an operative duration of ≤ 90 min were assigned to either the Classic LMA group or ETT group (n = 35 each). Primary outcomes included intraoperative ventilatory performance assessed by peak airway pressure (Ppeak), need for conversion of airway technique, and airway-related complications. Secondary outcomes included intraoperative hemodynamic and respiratory parameters, including heart rate (HR), systolic and diastolic blood pressure (SBP/DBP), oxygen saturation (SpO2), end-tidal carbon dioxide (ETCO2), Ppeak, minute ventilation (VE), and postoperative complications.
RESULTS: Baseline demographic and perioperative characteristics were comparable between groups. No significant differences were observed between the Classic LMA and ETT groups regarding intraoperative hemodynamic variables, SpO2, ETCO2, or VE. Ppeak was significantly higher in the ETT group (p < 0.001). During recovery, significant time-related changes were observed in hemodynamic and respiratory parameters in both groups, although no clinically significant intergroup differences were identified. Postoperative complications, including sore throat and laryngospasm, were infrequent and comparable between groups.
CONCLUSION: Classic LMA provided airway maintenance and ventilation comparable to ETT in short prone-position urologic surgeries and may be considered as a feasible airway device in patients meeting appropriate airway assessment criteria. Trial Registration: Iranian Registry of Clinical Trials (IRCT): IRCT20250729066688N1.