A comparison of clinical performance between i-gel and endotracheal tube in pediatric laparoscopic surgeries

홍정인; 이태영; 박상융; 최소론; 이승철; 정찬종; 김정호

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자료유형: 학술저널

저자정보: 홍정인 (동아대학교 의과대학 마취통증의학교실) 이태영 (동아대학교 병원 마취통증의학과) 박상융 (동아대학교) 최소론 (동아대학교) 이승철 (동아대학교) 정찬종 (동아대학교) 김정호 (동아대학교 의과대학 마취통증의학교실)

저널정보: 대한마취통증의학회(구 대한마취과학회) Anesthesia and Pain Medicine Anesthesia and Pain Medicine Vol.14 No.2

발행연도: 2019.1

수록면: 172 - 179 (8page)

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Background: The current evidence on the safe use of supraglottic airway for pediatric laparoscopic surgeries is limited. Although i-gel has been successfully used in adult laparoscopic surgeries, to our knowledge, no studies have compared it to the endotracheal tube (ETT) in pediatric laparoscopic surgeries. This study evaluated the effectiveness of i-gel over ETT with regards to the respiratory and hemodynamic parameters during pediatric laparoscopic surgeries. Methods: A total of 60 pediatric patients undergoing elective laparoscopic surgeries were randomly allocated to either the i-gel or ETT groups. Anesthetics used included ketamine, sevoflurane, and rocuronium. The primary outcome measured was the peak airway pressure (PAP) and the secondary outcomes measured were leak fraction, endtidal CO2, respiratory rate, insertion time, heart rate, blood pressure and perioperative complications. Results: The PAP during surgeries was higher in the ETT group than in the i-gel group. There were no statistically significant differences in the leak fraction, end-tidal CO2, and respiratory rate. The i-gel group had a shorter insertion time compared with the ETT group. The changes in heart rate were comparable in both groups. However, systolic and diastolic pressures were higher in the ETT group following intubation, before and after the creation of pneumoperitoneum. The incidence of perioperative complications was similar in both groups. Conclusions: The i-gel provided adequate ventilation with lower PAP compared with ETT. In addition, it provided minimal hemodynamic changes compared with ETT. Therefore, the i-gel may provide a suitable alternative to ETT in pediatric laparoscopic surgeries.

#Intubation #intratracheal #I-gel #Laparoscopy #Pediatrics.

참고문헌 (25)

참고문헌 신청

Valenza F / 2010 / Management of mechanical ventilation during laparoscopic surgery / Best Pract Res Clin Anaesthesiol 24:227~241

Manner T / 1998 / Lung compliance during laparoscopic surgery in paediatric patients / Paediatr Anaesth 8:25~29

Bannister CF / 2003 / The effect of insufflation pressure on pulmonary mechanics in infants during laparoscopic surgical procedures / Paediatr Anaesth 13:785~789

Ozdamar D / 2010 / Comparison of the effect of LMA and ETT on ventilation and intragastric pressure in pediatric laparoscopic procedures / Minerva Anestesiol 76:592~599

Sinha A / 2007 / ProSeal as an alternative to endotracheal intubation in pediatric laparoscopy / Paediatr Anaesth 17:327~332

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