摘要
目的观察麻醉期间吸入氧化亚氮(N2O)对双腔喉罩(PLMA)套囊内压的影响及几种处理方法的效果。方法择期手术患者60例,随机均分成四组,分别在PLMA套囊内预充空气(A组和D组)、50%N2O(B组)、生理盐水(C组)使套囊初始压力至20mmHg。术中吸入50%N2O,持续监测喉罩套囊内压。其中D组套囊内压一旦超过40mmHg即抽出套囊内部分气体使压力降至初始水平。结果A组喉罩套囊内压持续升高,B组和C组保持平稳,15min后三组喉罩套囊内压差异有统计学意义(P<0.05)。D组在(20±7)min时进行第一次抽气,抽气1～2次后D组套囊内压明显低于A组(P<0.05)。手术结束时,A组套囊内压明显高于B、C、D组(P<0.05)。拔除喉罩后,A组套囊内出现血迹的发生率明显高于B组(P<0.05)。结论麻醉期间吸入N2O使PLMA套囊内压明显升高,喉罩套囊内预充与吸入麻醉相同浓度的N2O、生理盐水或间歇抽出套囊内部分气体能有效防止套囊内压过度升高。
Objective To investigate the effect of nitrous oxide on the intracuff pressure of ProSeal laryngeal mask airway （PLMA） and intervention measures during anesthesia. Methods Sixty ASA class Ⅰ or Ⅱ patients undergoing elective operations were randomized into four groups. PLMA cuffs were inflated to 20 mmHg as initial pressure with air （group A and D）, 50% N2O （group B） and saline （group C）. 50% N2O with isoflurane and propofol were used to maintain anesthesia. During operation the intracuff pressure was monitored in all patients. When the intracuff pressure came to 40 mm Hg in group D,we deflated cuff to the initial pressure. Postoperative airway complications were recorded. Results The intracuff pressure significantly increased in group A while it remained stable in group B and group C （P〈0.05）. The first cuff deflation for group D was at （20±7） min. The intracuff pressure was lower in group D than that in group A by cuff deflation for 1 or 2 times （P〈0.05）. Blood contamination on PLMA after removal was more common in group A than that in group B （P〈0.05）. There was no significant difference in the incidence of sore throat, dysphagia and dysphonia among the four groups. Conclusion Nitrous oxide diffusion into PLMA increases the cuff pressure. Inflation of the cuff with the inspired gas mixture of N2O/oxygen,saline or cuff deflation during anaesthesia can prevent the increase of intracuff pressure.
出处
《临床麻醉学杂志》
CAS
CSCD
2008年第6期473-475,共3页
Journal of Clinical Anesthesiology
关键词
双腔喉罩
套囊内压
氧化亚氮
ProSeal laryngeal mask airway
Intracuff pressure
Nitrous oxide
