Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942010000100004
Brazilian Journal of Anesthesiology
Scientific Article

Tubo laríngeo com sucção descartável versus reutilizável para ventilação de pacientes submetidos à colecistectomia laparoscópica

Disposable versus reusable laryngeal tube suction for ventilation in patients undergoing laparoscopic cholecystectomy

Afshin Amini; Farid Zand; Masoud Maghbooli

http://dx.doi.org/10.1590/S0034-70942010000100004 Braz J Anesthesiol, vol.60, n1, p.32-41, 2010
PDF Português
PDF English
Downloads: 0
Views: 940

Resumo

JUSTIFICATIVA E OBJETIVOS: O tubo laríngeo com sucção (LTS-II) é uma versão recente dos dispositivos supraglóticos reutilizáveis que permitem a drenagem gástrica. Neste estudo prospectivo e aleatório comparam-se inserção e ventilação de LTS-II descartável (LTS-D) com a reutilizável (LTS-II) para manuseio das vias aéreas em condições associadas com pressão abdominal elevada induzida por pneumoperitônio. MÉTODO: Sessenta pacientes, ASA I e II, submetidos à colecistectomia laparoscópica eletiva foram aleatoriamente separados para receber LTS-D (n = 30) ou LTS-II (n = 30) para manutenção das vias aéreas. Após a indução da anestesia geral, os dispositivos foram inseridos, seu correto posicionamento foi verificado e a pressão de vazamento de ar foi medida. Facilidade de inserção, qualidade do selo das vias aéreas, visualização fibrobroncoscópica, risco de insuflação gástrica, inserção do tubo nasogástrico e morbidade faríngea pós-operatória foram avaliados. RESULTADOS: Os índices de sucesso da primeira e segunda tentativas foram comparados nos dois grupos (86% versus 93% e 96% versus 96% nos grupos LTS-D e LTS-II, respectivamente). Um paciente de cada grupo não pode ser intubado após três tentativas Após a insuflação, a ventilação falhou em um paciente no grupo LTS-D e em dois pacientes no LTS-II e os pacientes precisaram ser intubados com cânula traqueal. O tempo até o primeiro volume corrente ser fornecido pelo LTS-D e LTS-II foi de 20,8 ± 11,6 e 18,2 ± 4,8 segundos, respectivamente (p = 0,27), e o tempo de fixação e manipulação foi de 73,3 ± 18,5 e 65,5 ± 16,2 segundos, respectivamente (p = 0,096). Sonda nasogástrica foi inserida em todos os pacientes. Não foram observadas diferenças significativas nas queixas pós-operatórias. CONCLUSÕES: Foi possível obter vias aéreas seguras com os dois dispositivos em condições de pressão intra-abdominal elevada.

Palavras-chave

EQUIPAMENTOS, Máscara laríngea, EQUIPAMENTOS, Máscara laríngea

Abstract

BACKGROUND AND OBJECTIVE: The laryngeal tube suction II (LTS-II) is a recent version of reusable supraglottic airway devices allowing gastric drainage. In this prospective, randomized study we compared insertion and ventilation of disposable LTS-II (LTS-D) with reusable type (LTS-II) for airway management under conditions with elevated intra abdominal pressure induced by capnoperitoneum. METHODS: 60 ASA I and II patients undergoing elective laparoscopic cholecystectomy were randomized to receive either a LTS-D (n=30) or LTS-II (n=30) for airway management. After induction of general anaesthesia the devices were inserted, their correct placement was verified and airway leak pressure was measured. Ease of insertion, quality of airway seal, fiberoptic view, risk of gastric insufflation, insertion of nasogastric tube and postoperative pharyngeal morbidity were examined. RESULTS: First time and second time success rates were comparable for both groups (86% vs. 93% and 96% vs. 96% in LTS-D and LTS-II groups, respectively). One patient in each group could not be intubated after three attempts. After gas insufflation, ventilation of one patient in LTS-D and 2 patients in LTS-II groups was faulty and the patients were intubated with endotracheal tube. Time until delivery of first tidal volume for LTS-D and LTS-II was 20.8 ± 11.6 s, and 18.2 ± 4.8 seconds respectively (p = 0.27), fixation and manipulation time was 73.3 ± 18.5 and 65.5 ± 16.2 seconds, respectively (p = 0.096). Nasogastric tube insertion was successful in all patients. There were no significant differences in postoperative complaints. CONCLUSIONS: Both devices provide a secure airway under conditions of elevated intra abdominal pressure.

Keywords

EQUIPMENT, Laryngeal mask, EQUIPMENT, Laryngeal mask

References

Cook TM, Hommers C. New airways for resuscitation?. Resuscitation. 2006;69:371-387.

Genzwuerker HV, Dhonau S, Ellinger K. Use of the laryngeal tube for out-of-hospital resuscitation. Resuscitation. 2002;52:221-224.

Matioc AA, Olson J. Use of the laryngeal tube in two unexpected difficult airway situations: lingual tonsillar hyperplasia and morbid obesity. Can J Anaesth. 2004;51:1018-1021.

Winterhalter M, Kirchhoff K, Groschel W. The laryngeal tube for difficult airway management: a prospective investigation in patients with pharyngeal and laryngeal tumours. Eur J Anaesthesiol. 2005;22:678-682.

Mihai R, Knottenbelt G, Cook TM. Evaluation of the revised laryngeal tube suction: the laryngeal tube suction II in 100 patients. Br J Anaesth. 2007;99:734-739.

Amini A, Zand F, Sadeghi SE. A comparison of the disposable vs the reusable laryngeal tube in paralysed adult patients. Anaesthesia. 2007;62:1167-1170.

Asai T, Shingu K. The laryngeal tube. Br J Anaesth. 2005;95:729-736.

Asai T, Kawashima A, Hidaka I. Laryngeal tube: its use for controlled ventilation. Masui. 2001;50:1340-1341.

Ocker H, Wenzel V, Schmucker P. A comparison of the laryngeal tube with the laryngeal mask airway during routine surgical procedures. Anesth Analg. 2002;95:1094-1097.

Gaitini LA, Vaida SJ, Somri M. A randomized controlled trial comparing the ProSeal Laryngeal Mask Airway with the Laryngeal Tube Suction in mechanically ventilated patients. Anesthesiology. 2004;101:316-320.

Bein B, Carstensen S, Gleim M. A comparison of the Proseal Laryngeal Mask Airway, the Laryngeal Tube S and the oesophageal tracheal combitube during routine surgical procedures. Eur J Anaesthesiol. 2005;22:341-346.

Dorges V, Ocker H, Wenzel V. The Laryngeal Tube-S: a modified simple airway device. Anesth Analg. 2003;96:618-621.

Genzwurker H, Finteis T, Hinkelbein J. Erste klinische Erfahrungen mit dem neuen LTS: Ein Larynx-Tubus mit osophagealer Drainagemoglichkeit. Anaesthesist. 2003;52:697-702.

Cook TM. The laryngeal tube sonda (LTS) and the LTS II. Acta Anaesthesiol Scand. 2006;50:521-522.

Blunt MC, Burchett KR. Variant Creutzfeldt-Jakob disease and disposable anaesthetic equipment-balancing the risks. Br J Anaesth. 2003;90:1-3.

Lu PP, Brimacombe J, Yang C. ProSeal versus the classic laryngeal mask airway for positive pressure ventilation during laparoscopic cholecystectomy. Br J Anaesth. 2002;88:824-827.

Lim Y, Goel S, Brimacombe JR. The ProSeal laryngeal airway is an effective alternative to laryngoscope-guided tracheal intubation for gynaecological laparoscopy. Anaesth Intensive Care. 2007;35:52-56.

Roth H, Genzwuerker HV, Rothhaas A. The ProSeal laryngeal mask airway and the laryngeal tube suction for ventilation in gynaecological patients undergoing laparoscopic surgery. Eur J Anaesthesiol. 2005;22:117-122.

Kikuchi T, Kamiya Y, Ohtsuka T. Randomized prospective study comparing the laryngeal tube suction II with Proseal laryngeal mask airway in anesthetized and paralyzed patients. Anesthesiology. 2008;109:54-60.

Cook TM, Cranshaw J. Randomized crossover comparison of ProSeal Laryngeal Mask Airway with Laryngeal Tube Sonda during anaesthesia with controlled ventilation. Br J Anaesth. 2005;95:261-266.

Zand F, Amini A, Sadeghi SE. A comparison of the laryngeal tube-S and Proseal laryngeal mask during outpatient surgical procedures. Eur J Anaesthesiol. 2007;24:847-851.

5dd2efe40e8825364ec63493 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