Oxygen leakage around the laryngeal mask airway during laser treatment of port-wine stains in children.
Oxygen leakage around the laryngeal mask airway during laser treatment of port-wine stains in children.
复制标题
激光治疗儿童鲜红斑痣期间喉罩气道周围氧气泄漏。
DOI：
10.1213/00000539-199403000-00012
复制
发表时间：
1994
影响因子：
5.7
通讯作者：
B. Halmi
中科院分区：
文献类型：
--
作者：
R. Epstein;B. Halmi
闪光灯泵浦脉冲染料激光是目前治疗皮肤葡萄酒色斑的首选。在我们的实践中，大多数患有这些病变的儿童在全身麻醉下接受治疗。在临床上使用的能量水平下，有可能在补充氧气的情况下点燃头发;我们知道在通过面罩进行全身麻醉期间，有4例眉毛或睫毛被点燃。喉罩气道（LMA）最近已成为广泛使用，这种设备可能会降低火灾的风险，在治疗这些病变。因此，我们设计了这项研究，以检查在临床病例中面罩下氧气泄漏的程度，并将其与LMA的泄漏进行比较。在26个不同的场合，共20例患者，年龄为4个月至16岁。在自主通气过程中，所有病例的面罩周围都有高浓度的氧气泄漏（平均63% +/- 16%），但只有一例病例的LMA周围检测到浓度超过21%（P < 0.001）。在使用LMA控制通气期间，19%的病例中氧气在面罩周围泄漏。使用LMA可显著降低潜在氧气泄漏到激光场中的发生率，建议在这些情况下使用，并保留自主通气。我们建议在激光治疗面部葡萄酒色斑时测量口腔处的氧浓度，以确认喉部已被隔离。（250字处删节）
The flash-lamp pumped pulsed dye laser is the current treatment of choice for cutaneous port-wine stains. In our practice, most children with these lesions are treated under general anesthesia. At energy levels used clinically, it is possible to ignite hair in the presence of supplemental oxygen; we are aware of four cases in which either the eyebrows or eyelashes were ignited during the administration of general anesthesia via a face mask. The laryngeal mask airway (LMA) recently has become widely available and this device might decrease the risk of fire during treatment of these lesions. We therefore designed this study to examine the extent of oxygen leakage under the mask during clinical cases, and to compare this with the leakage present with the LMA. A total of 20 patients aged 4 mo to 16 yr were studied on 26 separate occasions. During spontaneous ventilation, high concentrations of oxygen leaked around the mask in every case (mean 63% +/- 16%), but in only one case was a concentration more than 21% detected around the LMA (P < 0.001). During controlled ventilation with the LMA, oxygen leaked around the mask in 19% of cases. Use of the LMA markedly decreases the incidence of potential oxygen leakage into the laser field, and is recommended for use, with preservation of spontaneous ventilation, during these cases. We suggest measuring oxygen concentrations at the mouth for laser treatment of facial port-wine stains to confirm that the larynx has been isolated.(ABSTRACT TRUNCATED AT 250 WORDS)