Contrast research of proseal laryngeal mask airway and esophageal tracheal combitube used in difficult airway patients

Abstract

Objective To compare the effect of proseal laryngeal mask airway(PLMA)and esophageal tracheal combitube(ETC)used in adult patients of difficult airway in perioperation.Methods Forty ASA Ⅰ-Ⅱadult patients of difficult airway were randomly divided into two groups:PLMA group and ETC group,each group was 20 cases.After intravenous anesthesia induction,PLMA or ETC was inserted by routine methods.The number of intubation,intubation time and time to surgery were recorded.The systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)were recorded before intubation (T_1),during after intubation(T_2),at 1 min(T_3),5 min(T_4),10 min(T_5)after intubation,during extubation(T_6).The intubation,the extubation and the maintain ventilation process of the respiratory complications and respiratory damage were recorded.Results All patients in PLMA group and ETC group achieved satisfactory lung ventilation at the first attempt.The number of intubation,intubation time and time to surgery were not different between the two groups(P＞0.05).SBP,DBP,HR at T_2,T_3,T_6 in ETC group [T_2:(143.2±11.4)mm Hg(1mm Hg=0.133kPa),(86.9±10.7)mm Hg,(145.8±10.2)times/min,T_3:(140.0±11.3)mm Hg,(84.5±10.7)mm Hg,(142.5±11.5)times/min,T_6:(147.7±11.3)mm Hg,(87.2±9.7)mm Hg,(145.4±10.9)times/min]were significantly higher than those in PLMA group[T_2:(123.5±12.7)mm Hg,(72.6±11.4)mm Hg,(129.0±11.0)times/min,T_3:(120.0±11.5)mm Hg,(69.7±10.5)mm Hg,(125.7±10.6)times/min,T_6:(122.5±11.6)mm Hg,(71.4±9.4)mm Hg,(127.8±11.3)times/min]and at T_1 in ETC group[(122.7±12.1)mm Hg,(74.1±9.6)mm Hg,(121.0±11.8)times/min](P<0.05).Respiratory complications and damage were no significant difference between the two groups(P＞0.05).Conclusion PLMA and ETC can achieve satisfactory lung ventilation used in adult patients of difficult airway in perioperation,they are safe and effective airway management device,but PLMA used in adult patients of difficult airway in perioperation is better than ETC in keeping stable hemodynamics and producing less stress responses. Key words: Laryngeal masks; Esophageal tracheal combitube; Difficult airway