摘要
目的探讨双管喉罩与气管插管用于全身麻醉妇科腹腔镜手术的安全性和可行性。方法 2009年1月5月择期妇科腹腔镜手术患者60例,ASAⅠ～Ⅱ级,随机分为喉罩组(P组)和气管插管组(T组)。记录入室基础值(T0),置罩(管)前(T1),置罩(管)后即刻(T2),置罩(管)后5min(T3),拔除罩(管)即刻(T4),拔除罩(管)后5min(T5)的收缩压(systolic pressure,SBP),舒张压(diastolic pressure,DBP),心率(heart rate,HR)和脉搏血氧饱和度(pulse oxygen saturation,SpO2),喉罩和气管插管控制呼吸时气腹前后不同时段的气道峰压(airway.maximum pressure,Pmax),潮气量(vital volume,VT)和呼气末二氧化碳分压(endtidal CO2,PETCO2)。记录插罩(管)成功率,及相关并发症。结果 T2时T组SBP,DBP和HR显著高于P组(P<0.05),两组术中通气均满意;Pmax,VT和PETCO2组间比较各时点无差异(P>0.05)。气腹后Pmax和PETCO2组内比较均高于气腹前,差异有统计学意义(P<0.05)。置罩(管)成功率组间比较差异无统计学意义,拔罩(管)期及术后24h并发症,喉罩组明显低于气管导管组,差异显著(P<0.05)。结论双管喉罩用于全麻妇科腹腔镜手术通气效果满意,安全可行。
Objective To explore the safety and efficacy of proseal laryngeal mask airway （PLMA） in general anesthesia during gynecologic laparoscopic procedure. Methods A total of 60 patients from January to May of 2009, ASA Ⅰ to Ⅱ, undergoing electively gynecologic laparoscopic surgery, were randomly assigned into PLMA group（group P）or endotracheal intubation group （group T）. SBP, DBP, HR and SpO_2 were monitored on patients’arrival operating room,before and 5 min after PLMA insertion or endotracheal intubation, 5 min after PLMA or endotracheal extraction airway.Maximum pressure （P_max）, vital volume （V_T）, end tidal CO_2 （P_ETCO_2） were recorded before and after artificial pneumoperitoneum （APP）. Results SBP, DBP and HR of group T were higher after endotracheal intubation than that of group P after PLMA insertion （P0.05）. There were no significant differences in P_max, V_T and P_ETCO_2 between group T and group P before and during APP. There were no significant differences in successful rate of PLMA insertion or endotracheal intubation between the two groups,but the complications in group P were lower than that in group T after surgery （P0.05）. Conclusion PLMA is safe and efficient in general anesthesia during gynecologic laparoscopic procedures.
出处
《华西医学》
CAS
2010年第5期910-912,共3页
West China Medical Journal
关键词
双管喉罩
妇科腹腔镜手术
气管插管
Proseal laryngeal mask airway
Gynecologic laparoscopic surgery
Endotracheal intubation
