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Analysis of the effect of diaphragm ultrasound guidance on the timing of laryngeal mask removal in pediatric inguinal hernia repair
Received date: 2023-05-17
Online published: 2023-09-26
Objective To investigate the feasibility and safety of using diaphragmatic ultrasound to guide timing of laryngeal mask extraction during anaesthesia for laparoscopic inguinal hernia surgery in children. Methods A total of 140 children undergoing laparoscopic inguinal hernia repair surgery were selected, and the children were randomly divided into two groups: the group with laryngeal mask extraction guided by diaphragmatic ultrasound (Group D) and the group with laryngeal mask extraction guided by awake (group A). The two groups were instructed on the timing of laryngeal mask extraction according to different ways, and the incidence of adverse events, such as difficulty in pulling out, cough, laryngospasm, bronchospasm, and pharyngeal pain, were compared between the two groups during and after the extraction, the analysis compared the incidence and management of peripheral oxygen desaturation between the two groups. Results The rates of difficulty in pullout and laryngospasm in group D were both lower than those in group A, and the number of cases of adverse events in group D was lower than that in group A, the difference was statistically significant. The incidence of oxygen desaturation after removal of the laryngeal mask was lower in group D than in group A, and the difference was statistically significant.The time from the end of surgery to removal of the laryngeal mask and the steward awakening score up to 4 points in group D were shorter than those in group A, and the differences were statistically significant. Conclusion During awakening from anaesthesia for laparoscopic inguinal hernia surgery in children, monitoring the rate of change in diaphragmatic thickness with ultrasound can lead to better guidance in the extraction of laryngeal mask with a lower incidence of adverse effects and greater safety.
Key words: inguinal hernia; diaphragm; ultrasonic; children; laryngeal mask
Jie LIU , Tao WANG , Lihua JIANG , Yinlong HOU , Wenlong GAO , Zhenghua. DONG . Analysis of the effect of diaphragm ultrasound guidance on the timing of laryngeal mask removal in pediatric inguinal hernia repair[J]. The Journal of Practical Medicine, 2023 , 39(16) : 2085 -2089 . DOI: 10.3969/j.issn.1006-5725.2023.16.012
| 1 | SANDERS D L, WAYDIA S. A systematic review of randomised control trials assessing mesh fixation in open inguinal hernia repair[J]. Hernia,2014,18(2):165-176. |
| 2 | 梁峰,李飞,聂双发,等. 疝环充填与下腹正中切口腹膜前间隙无张力疝修补术的对比[J]. 实用医学杂志,2017,33(21):3597-3601 |
| 3 | 高宇,刘皓昕,刘绪华,等. 喉罩与气管插管在患儿全身麻醉气道管理中的安全性Meta分析[J]. 临床麻醉学杂志,2021,37(1):59-65. |
| 4 | KOO C H, LEE S Y, CHUNG S H,et al. Deep vs awake extubation and LMA removal in terms of airway complications in paediatric patients undergoing anesthesia: A systematic review and meta?analysis[J]. J Clin Med,2018,7(10):353. |
| 5 | ABBASI S, SIDDIQUI K M, QAMAR-UL-HODA M. Adverse Respiratory Events After Removal of Laryngeal Mask Airway in Deep Anesthesia Versus Awake State in Children: A Randomized Trial[J]. Cureus,2022,14(4):e24296. |
| 6 | DININO E, GARTMAN E J, SETHI J M,et al. Diaphragm ultra- sound as a predictor of successful extubation from mechanical ventilation [J]. Thorax,2014,69(5) : 423-427. |
| 7 | 樊麦英,罗杰英,文辉,等. 超声监测膈肌运动指标对机械通气撤机的指导价值[J]. 中华危重病急救医学,2018,30 (11): 1041-1045. |
| 8 | FAYSSOIL A, NGUYEN LS, OGNA A, et al. Diaphragm sniff ultrasound: Normal values, relationship with sniff nasal pressure and accuracy for predicting respiratory involvement in patients with neuromuscular disorders[J]. PLoS One,2019,14(4): 0214288. |
| 9 | GARCIA-SANTIBANEZ R, ZAIDMAN C M, RUSSELL T,et al. Serial diaphragm ultrasound studies in neuralgic amyotrophy with bilateral phrenic neuropathies[J]. Muscle Nerve,2017,56(6):E168-E170. |
| 10 | 程滔,邢琴,杨明施,等. 超声评估膈肌功能对机械通气患者撤机的指导价值[J]. 中华急诊医学杂志,2020,29(6):850-854. |
| 11 | 郎珈馨,易杰.围手术期膈肌超声评估术后肌松残余的可行性[J].中国医学科学院学报,2021,43(2):205-210. |
| 12 | DE GOEDE B, TIMMERMANS L, VAN KEMPN B J,et al.Risk factors for inguinal hernia in middle?aged and elderly men:results from the Rotterdam Study[J]. Surgery,2015, 157(3):540?546. |
| 13 | 张竞泾,卞谦,张晓颖,等. 临床综合条件下七氟醚抑制小儿喉罩拔除反应的半数有效浓度[J]. 中华麻醉学杂志,2018,38(1):59-61. |
| 14 | MCCOOL F D, MANZOOR K, MINAMI T. Disorders of the diaphragm[J]. Clin Chest Med, 2018, 39(2): 345?360. |
| 15 | 姚叶林,孙颖华,陶金好,等. 超声测量儿童膈肌前中后部运动的可重复性研究[J]. 中华物理医学与康复杂志,2020,42(7):601-605. |
| 16 | ZAMBON M, GRECO M, BOCCHINO S,et al.Assessment of diaphragmatic dysfunction in the critically ill patient with ultrasound:a systematic review[J]. Intensive Care Med,2017,43(1):29-38. |
| 17 | CAPPELLINI I, OSTENTO D, LORIGA B, et al. Comparison of neostigmine vs. sugammadex for recovery of muscle function after neuromuscular block by means of diaphragm ultrasonography in microlaryngeal surgery: A randomised controlled trial[J]. Eur J Anaesthesiol,2020,37(1):44-51. |
| 18 | RAMGOLAM A, HALL G L, ZHANG G, et al. Deep or awake removal of laryngeal mask airway in children at risk of respiratory adverse events undergoing tonsillectomy-a randomised controlled trial[J]. Br J Anaesth,2018,120(3):571-580. |
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