Comparison Of Two Different Pediatric Laryngeal Mask Insertion And Position Methods

Objective:Based on the observation of the clinical anesthesia effect of laryngeal mask ventilation in children under general anesthesia,the advantages of visible ultrasound technology in assessing laryngeal mask airway management in children under general anesthesia were analyzed.Method:156 children with laryngeal mask ventilation under general anesthesia were selected from the first hospital of Jilin University from January to December 2019.They were 3-6 years old and graded ASA I-II.They were divided into two groups according to the random number table method.The traditional standard method or ultrasonic method were used to locate the laryngeal mask,and the weight,gender,age,ASA grading,Mallampati grading,operation time,laryngeal mask indwelling time,general types of surgery in two groups of children were recorded and compared;Fiberoptic bronchoscopy evaluation was carried out for two groups of children after localization,and the classification was recorded;The first success rate of laryngeal mask insertion,the success rate after the adjustment of localization,and the rate of airway intervention during operation（including re-inserting of laryngeal mask,increasing or decreasing of insertion depth without removal of laryngeal mask,adjusting the neck position and the volume of air in the cuff）,the minimum cuff pressure for meeting the ventilation(CIP_min),the end tidal carbon dioxide pressure(P_etCO₂)for 20 minutes,peak airway pressure（peak）for 5 minutes,oropharyngeal leakage pressure when the intraoperative pressure is 60 cmH₂O(OLP₆₀)and intraoperative leakage rate were observed and recorded;The complications of recovery and postoperative period such as inspiratory wheezing,VAS score and blood staining rate when removing the laryngeal mask,VAS score at swallowing,postoperative nausea,vomiting and hoarseness were observed and recorded.Result:The incidence of ideal position（fiberoptic bronchoscopy was rated I）was increased from 12.8%in the traditional standard group to 35.9%in the ultrasound positioning group by ultrasound（P<0.001）;The incidence of positioning standard（fiberoptic bronchoscopy was rated I and II）was increased from 61.5%in the traditional standard group to 92.3%in the ultrasound positioning group（P<0.01）;There was no statistically difference in the first success rate of laryngeal mask insertion of the two groups of children（P<0.001）;But the rate of intraoperative air leakage,peak airway pressure at 5 minutes,intervention rate,P_etCO₂ at 20 minutes and CIP_minin were significantly lower in the ultrasound positioning group than those in the traditional standard group（P<0.05）;The incidence of aspiration wheezing,VAS score and blood staining rate when removing the laryngeal mask,VAS score at swallowing,postoperative nausea,vomiting and hoarseness in the ultrasonic positioning group were significantly lower than those in the traditional standard group,and the difference is statistically significant（P<0.05）.Conclusion:Ultrasound can more accurately locate laryngeal mask,improve ventilation conditions and reduce related complications of oropharynx.