第三代SLIPA喉罩(SLIPA-3G)与传统喉罩在腹腔镜胆囊切除术中应用的比较：一项随机前瞻性研究

贵州医科大学    麻醉与心脏电生理课题组

翻译：张中伟  编辑：潘志军  审校：曹莹

背景：

第三代SLIPA喉罩(SLIPA-3G)是新一代声门上呼吸道装置(SAD)，它是一次性设备，其密封压力可随呼吸道压力的改变而发生动态变化。这项研究比较了SLIPA-3G和传统喉罩（LMAS）在腹腔镜胆囊切除术中的应用。

方法：

220名计划接受腹腔镜胆囊切除术的患者被随机分配到SLIPA-3G组或LMAS组。记录患者不同时间点的血流动力学参数、置入难易程度、光纤切面、不同时间点的口咽部漏气压力(OLP)及SAD相关并发症。

结果：

LMAS组术后即刻OLP显著高于SLIPA-3G组(31.34±6.99cmH2O vs.28.94±6.01cmH2O，P=0.008，95%CI0.62~4.17)。气腹诱导后至手术结束时，两组的OLP差异无统计学意义。SLIPA-3G组在手术过程中OLP逐渐增加(P值=0.035)，而LMAS组则无明显变化(P值=0.945)。两组患者的血流动力学参数、置管时间、置管成功率、光纤切面及并发症发生率均无显著差异。

结论：

SLIPA-3G和LMAS与OLP、血流动力学参数、插入的容易程度、光纤切面以及在腹腔镜胆囊切除术中使用的并发症发生率相关。SLIPA-3G可作为腹腔镜手术患者LMA的有效替代品。

原始文献来源：

Hongna Fan, Lin Li, Lei Zhu, et al.Comparison of the third-generation streamlined liner of the pharynx airway (SLIPA-3G) with the laryngeal mask airway supreme for laparoscopic cholecystectomy: a randomized prospective study.[J]. BMC Anesthesiol(2022) 22:97

英文原文                        

Comparison of the third-generation

streamlined liner of the pharynx airway

(SLIPA-3G) with the laryngeal mask airway

supreme for laparoscopic cholecystectomy:

a randomized prospective study

Abstract

Background:The third-generation streamlined liner of the pharynx airway (SLIPA-3G) is a new-generation supra-glottic airway device (SAD) that is non-cuffed and disposable, with a sealing pressure that varies dynamically with the airway pressure. This study compared the SLIPA-3G with the laryngeal mask airway supreme (LMAS) in patients undergoing laparoscopic cholecystectomy.

Method:Two hundred and twenty patients scheduled for laparoscopic cholecystectomy were randomly allocated to either the SLIPA-3G group or the LMAS group. Data were collected on the patients’ hemodynamic parameters at

different time points, ease of insertion, fiberoptic view, oropharyngeal leak pressure (OLP) at different time points and SAD-related complications.

Results:The mean OLP immediately after device placement in the LMAS group was significantly higher than that of the SLIPA-3G group (31.34 ± 6.99  cmH2O vs.28.94 ± 6.01 cmH2O, P = 0.008, 95% CI 0.62–4.17). The OLPs of the two groups were not significantly different after the induction of a pneumoperitoneum until the end of surgery. The OLP increased gradually through the course of the operation in the SLIPA-3G group (P value = 0.035) but not in the LMAS group (P value = 0.945). There was no significant difference between the two groups in hemodynamic parameters, insertion time and success rate, fiberoptic view and complication rate.

Conclusion:The SLIPA-3G and LMAS were associated with comparable OLPs, hemodynamic parameters, ease of insertion, fiberoptic views and complication rates when used during laparoscopic cholecystectomy. The SLIPA-3G can be used as an effective alternative to the LMAS in patients undergoing laparoscopic surgeries.