南方医科大学学报

南方医科大学学报 ›› 2023, Vol. 43 ›› Issue (3): 460-465.doi: 10.12122/j.issn.1673-4254.2023.03.17

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理想体质量可作为低体质量患者喉罩型号的选择依据：137例随机对照临床试验

郭志华，王志鹏，季文进   

  1. 南方医科大学附属广东省人民医院（广东省医学科学院）麻醉科，广东 广州 510080
  • 出版日期:2023-03-20 发布日期:2023-03-20

Selection of classic laryngeal mask airway size based on ideal body mass in patients with low body mass index: a randomized trial

GUO Zhihua, WANG Zhipeng, JI Wenjin   

  1. Department of Anesthesiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
  • Online:2023-03-20 Published:2023-03-20

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摘要： 目的 对比基于理想体质量与实际体质量确定经典喉罩型号对低体质量指数患者喉罩首次放置成功率的影响。方法 选取137例18~60岁、体质量指数低于18.5 kg/m2、根据实际体质量和理想体质量选择喉罩型号时存在差异的患者，以随机数字表法将患者分为理想体质量组（n=68）和实际体质量组（n=69）。理想体质量组患者根据公式计算体质量，实际体质量组则根据实际测量体质量，作为经典喉罩型号选择依据。记录喉罩首次放置成功率、总体成功率、纤维支气管镜下视野等级、喉罩漏气压力、麻醉维持期间及麻醉复苏期喉罩相关并发症。结果 理想体质量组患者喉罩首次放置成功率高于实际体质量组（86.8% vs 68.1%，P=0.016），理想体质量组患者较实际体质量组使用较大型号喉罩（P<0.005），且具有较好的纤支镜视野评分（P=0.001）和较高的气道密封压（P<0.005），两组患者吸气气道峰压的差异无统计学意义（P=0.154），且麻醉维持期间和复苏期喉罩相关并发症发生率的差异无统计学意义（P>0.05）。结论 低体质量指数患者基于身高、性别的理想体质量选择经典型喉罩型号能显著提高喉罩首次放置成功率。

关键词: 低体质量指数；喉罩型号；理想体质量；首次放置成功率

Abstract: Objective To compare the effect of laryngeal mask airway (LMA) size selection based on ideal and actual body mass on the success rate of first insertion in patients with low body mass index (BMI). Methods This study was performed in 137 patients aged 18-60 years with BMI below 18.5 kg/m2, in whom discrepancies occurred in the selection of LMA size based on their actual body mass and the ideal body mass. The patients were randomized divided into ideal body mass group and actual body mass group, in which the size of LMA was selected based on the ideal body mass and their actual body mass, respectively. The success rate of first LMA insertion, overall success rate, fiberoptic visual field grade, leakage pressure, and LMA-related complications of the patients were recorded during the maintenance and recovery of anesthesia. Results The success rate of first LMA insertion was significantly higher in ideal body mass group than in the actual body mass group (86.8% vs 68.1%, P=0.016). Compared with those in the actual body mass group, the patients in the ideal body mass group used larger LMA (P<0.005) and had better fiberoptic field scores (P=0.001) and higher airway seal pressure (P<0.005). The peak inspiratory pressure (P=0.154) or the incidence of LMA-related complications during anesthesia maintenance and recovery did not differ significantly between the two groups (P>0.05). Conclusion The size selection of LMA based on the ideal body mass of the patients, determined according to their height and sex, can significantly improve the success rate of first LMA insertion in patients with low BMI.

Key words: low body mass index; size of laryngeal mask airway; ideal mass; success rate of first insertion