BACKGROUND ProSeal (PLMA) and Supreme (SLMA) laryngeal mask airways are effective ventilator devices with distinctive designs that may require different anaesthetics for insertion. Sevoflurane induction provides acceptable conditions for laryngeal mask insertion, and remifentanil significantly decreases the minimum alveolar concentration of sevoflurane required for that insertion. The study aimed to evaluate the optimal end-tidal (ET) sevoflurane concentration for successful insertion of PLMA versus SLMA in patients receiving a remifentanil infusion without a neuromuscular blocking agent. METHODS Altogether, 45 patients ASA (American Society Anaesthesiologists) physical status I-II, aged 18-60 years were scheduled for elective ambulatory surgery. Exclusion criteria were a difficult airway, recent respiratory infection, reactive airway, obstructive sleep apnoea syndrome, gastric aspiration's risk factors, pregnancy, and lactation. Patients were randomly allocated to receive the SLMA or the PLMA. Sevoflurane induction with co-administration of remifentanil was performed at an effect-site concentration of 4 ng mL- 1. ET50 was calculated with a modified Dixon's up-and-down method (starting at 2.5% in steps of 0.5%). Predetermined sevoflurane concentration was kept constant during the 10 min before LMA insertion. Patient's response to LMA insertion was classified as "movement" or "no movement". Sevoflurane ET50 was determined as the midpoint concentration of all the independent pairs that manifested crossover from "movement" to "no movement". RESULTS The ET50 sevoflurane concentration co-administered with remifentanil required for PLMA insertion was 1.20 ± 0.41% (95% confidence interval 0.76 to 1.63%). For SLMA insertion, it was 0.55 ± 0.38% (95% confidence interval 0.14 to 0.95%) (p = 0.019). CONCLUSIONS The end-tidal sevoflurane concentration with co-administered remifentanil required to allow insertion of the SLMA was 54% lower than that needed for inserting the PLMA. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT03003377. Retrospectively registered. Date of registration: December 28, 2016.

中文翻译：

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在目标控制的瑞芬太尼输注过程中，Supreme™喉罩气道插入所需的七氟醚浓度低于ProSeal™喉罩气道插入：一项前瞻性随机对照研究。

背景技术ProSeal（PLMA）和Supreme（SLMA）喉罩气道是有效的呼吸机设备，其独特的设计可能需要不同的麻醉剂才能插入。七氟醚的诱导为喉罩的插入提供了可接受的条件，瑞芬太尼显着降低了该插入所需的七氟醚的最低肺泡浓度。该研究旨在评估接受瑞芬太尼输注而没有神经肌肉阻滞剂的患者中，成功插入PLMA和SLMA的最佳潮气末（ET）七氟醚浓度。方法总共有45例年龄18至60岁的ASA（美国麻醉医师协会）I-II型患者计划进行择期门诊手术。排除标准为困难气道，近期呼吸道感染，反应性气道，阻塞性睡眠呼吸暂停综合征，胃抽吸的危险因素，妊娠和哺乳期。患者被随机分配接受SLMA或PLMA。在4 ng mL-1的作用位点浓度下，与瑞芬太尼共同给药进行七氟醚诱导。ET50用改良的Dixon上下法计算（从2.5％开始，以0.5％的步长）。在LMA插入之前的10分钟内，预定的七氟醚浓度保持恒定。患者对LMA插入的反应分为“运动”或“无运动”。七氟醚ET50被确定为所有独立对的中点浓度，这些对表现出从“运动”到“无运动”的交叉。结果PLMA插入所需的ET50七氟醚与瑞芬太尼共同使用的浓度为1.20±0.41％（95％置信区间0.76至1.63％）。对于SLMA插入，该值为0.55±0.38％（95％置信区间0.14至0.95％）（p = 0.019）。结论允许插入SLMA所需的潮气末七氟醚与瑞芬太尼的共同给药浓度比插入PLMA所需的浓度低54％。试验注册Clinicaltrials.gov标识符：NCT03003377。追溯注册。注册日期：2016年12月28日。结论允许插入SLMA所需的潮气末七氟醚与瑞芬太尼的共同给药浓度比插入PLMA所需的浓度低54％。试验注册Clinicaltrials.gov标识符：NCT03003377。追溯注册。注册日期：2016年12月28日。结论允许插入SLMA所需的潮气末七氟醚与瑞芬太尼的共同给药浓度比插入PLMA所需的浓度低54％。试验注册Clinicaltrials.gov标识符：NCT03003377。追溯注册。注册日期：2016年12月28日。