Результаты рандомизированного сравнительного исследования надгортанных воздуховодов второго поколения при операции остеосинтеза орбиты

The objective: to assess and compare supraglottic airways of LMA-Supreme and i-gel during orbital osteosynthesis.Subjects and methods. 91 patients were included into the study. All of them underwent osteosynthesis of the orbit. The patients were randomly divided into two groups. LMA-Supreme group included 42 patients, while i-gel group included 49 patients.Results. The parameters of hemodynamics, gas exchange, and artificial pulmonary ventilation (APV) did not basically differ between the groups at different stages of the study. The oropharyngeal leak pressure differed between the groups at the end of surgery and made (Me – median, Q1 and Q3 – upper and lower quartiles): 28.0 (22.0; 30.0) and 21.0 (19.0; 27.0) mm WG the LMA-Supreme and i-gel groups, respectively; p = 0.021. A significant difference was observed in the insertion time of supraglottic airways (Me is the median, Q1 and Q3 are the upper and lower quartiles): 27.5 (19.3; 36.5) sec. for LMA-Supreme and 15.0 (13.8; 25.0) sec. – for i-gel; p = 0.001. When inserting the LMA-Supreme duct in 33 (78.6%) patients, jaw thrust maneuver, extension of the neck, etc. were required; while in the i-gel group, similar maneuvers were necessary in 18 (36.7%) patients; p < 0.001. The number of postoperative complications was minimal in both groups.Conclusion. Both supraglottic airways can be used with equal efficacy in osteosynthesis of the orbit. At the same time, the i-gel duct has an advantage over the LMA-Supreme in speed and simplicity of insertion. The LMA-Supreme had greater leak pressure at the end of surgery, which might be an advantage in patients requiring greater peak inspiratory pressure to provide effective APV.Цель: провести сравнительную оценку надгортанных воздуховодов LMA-Supreme и i-gel при операции остеосинтеза орбиты.Материал и методы. В исследование включен 91 больной. Всем проводилась операция остеосинтеза орбиты. Пациенты рандомизированы на две группы: 42 – составили группу LMA-Supreme, 49 ‒ группу i-gel.Результаты. Параметры гемодинамики, газообмена и искусственной вентиляции легких (ИВЛ) в основном не отличались между группа- ми на различных этапах исследования. Орофарингеальное давление утечки отличалось между группами в конце операции и составляло (Me – медиана, Q1 и Q3 – верхний и нижний квартили): 28,0 (22,0; 30,0) и 21,0 (19,0; 27,0) мм вод. ст. в группах LMA-Supreme и i-gel соот- ветственно; p = 0,021. Получена достоверная разница по времени установки надгортанного воздуховода (Me – медиана, Q1 и Q3 – верхний и нижний квартили): 27,5 (19,3; 36,5) с. для LMA-Supreme и 15,0 (13,8; 25,0) с – для i-gel; p = 0,001. При установке воздуховода LMA-Supreme у 33 (78,6%) пациентов требовались выведение нижней челюсти, разгибание шеи и прочее, в группе i-gel аналогичные маневры необходимо было выполнить у 18 (36,7%) пациентов; p < 0,001. Количество послеоперационных осложнений было минимальным в обеих группах.Заключение. Оба устройства c одинаковой эффективностью могут использоваться при операциях остеосинтеза орбиты. При этом воз- духовод i-gel имеет преимущество перед LMA-Supreme в скорости и простоте установки. Воздуховод LMA-Supreme продемонстрировал большее давление утечки в конце оперативного вмешательства, что может быть преимуществом у пациентов, требующих большего пикового давления на вдохе для эффективной ИВЛ

Results of the randomized comparative study of second-generation supraglottic airways in orbital osteosynthesis

The objective: to assess and compare supraglottic airways of LMA-Supreme and i-gel during orbital osteosynthesis.Subjects and methods. 91 patients were included into the study. All of them underwent osteosynthesis of the orbit. The patients were randomly divided into two groups. LMA-Supreme group included 42 patients, while i-gel group included 49 patients.Results. The parameters of hemodynamics, gas exchange, and artificial pulmonary ventilation (APV) did not basically differ between the groups at different stages of the study. The oropharyngeal leak pressure differed between the groups at the end of surgery and made (Me – median, Q1 and Q3 – upper and lower quartiles): 28.0 (22.0; 30.0) and 21.0 (19.0; 27.0) mm WG the LMA-Supreme and i-gel groups, respectively; p = 0.021. A significant difference was observed in the insertion time of supraglottic airways (Me is the median, Q1 and Q3 are the upper and lower quartiles): 27.5 (19.3; 36.5) sec. for LMA-Supreme and 15.0 (13.8; 25.0) sec. – for i-gel; p = 0.001. When inserting the LMA-Supreme duct in 33 (78.6%) patients, jaw thrust maneuver, extension of the neck, etc. were required; while in the i-gel group, similar maneuvers were necessary in 18 (36.7%) patients; p < 0.001. The number of postoperative complications was minimal in both groups.Conclusion. Both supraglottic airways can be used with equal efficacy in osteosynthesis of the orbit. At the same time, the i-gel duct has an advantage over the LMA-Supreme in speed and simplicity of insertion. The LMA-Supreme had greater leak pressure at the end of surgery, which might be an advantage in patients requiring greater peak inspiratory pressure to provide effective APV