日本人に適した新しい声門上器具の臨床的有用性の評価

背景声门上气道（SGAs）被认为是可靠的。然而，与SGAs有关的一些复杂问题仍然是一个问题。本研究的目的是比较i-gel气道对三维打印气道模型施加的力与3D打印改良SGA施加的力。在Thiel防腐尸体上进行初步实验后，我们根据五名女性患者的计算机断层扫描（CT）数据创建了一个3D打印改良SGA（mSGA）和五个3D打印气道模型。我们比较了i-gel和mSGA在3D打印气道模型中对喉部施加的力。此外，还比较了将气道装置插入3D打印气道模型和给予不同水平压力控制通气的潮气量。以下数据分别表示i-gel和mSGA的中位数[最小值-最大值]。套囊部分施加的力如下：腹侧：20.8 N [13.8-27.0]和9.4 N [6.5-20.0]，近端：1.3 N [0- 5.0]和2.0 N [0-5.0]，背侧部分：12.0 N [5.6-22.0]和8.0 N [2.0-9.0]。因此，mSGA袖带腹侧和背侧部分施加的力显著较低。我们还发现在PCV为10、15和20 cmH 2 O的情况下，mSGA的潮气量显著更高。我们的研究表明，与i-gel相比，更薄和更窄的mSGA袖带减少了施加在3D打印气道模型上的力，并可能导致减少SGA相关并发症而不损害通气。

Background. Supraglottic airways (SGAs) are acknowledged as being reliable. However, several complications related to SGAs are still an issue. The aim of the current study was to compare the force exerted by the i-gel airway on a three-dimensional printed airway model with that exerted by a 3D printed modified SGA.Methods. After a preliminary experiment in Thiel embalmed cadavers, we created a 3D printed modified SGA (mSGA) and five 3D printed airway models based on computed tomography (CT) data from five female patients. We compared the force exerted by the i-gel and mSGA on the larynx in the 3D printed airway models. In addition, tidal volumes with insertion of the airway devices into the 3D printed airway model and administration of different levels of pressure controlled ventilation were compared.Results. The data below indicates median [min-max] for the i-gel and mSGA, respectively. The forces exerted by the cuff parts were as follows: ventral: 20.8 N [13.8-27.0] and 9.4 N [6.5-20.0], proximal: 1.3 N [0-5.0] and 2.0 N [0-5.0], and dorsal parts: 12.0 N [5.6-22.0] and 8.0 N [2.0-9.0], respectively. Hence, the force exerted by the ventral and dorsal parts of the mSGA cuff was significantly lower. We also found significantly higher tidal volumes with the mSGA under PCV of 10, 15, and 20 cmH2O.Conclusion. Our study indicated that the thinner and narrower mSGA cuff compared with the i-gel reduced the force exerted on a 3D printed airway model, and might lead to reduction of SGA-related complications without impairing ventilation.