摘要
目的观察在小儿全身麻醉中喉罩与气管插管对小儿血流动力学和气道压的影响，并探讨其对小儿麻醉的安全性。方法选择3～9岁，美国麻醉医师协会（ASA）Ⅰ或Ⅱ级的择期全身麻醉手术患儿30例，随机分成喉罩组（^组）和气管插管组（B组）各i5例。麻醉诱导后插入喉罩或气管导管行机械通气，观察患儿入室时（T0）、诱导后（T1）、插入喉罩或气管导管即刻（T2）、1min（T3）、3min（T4）、5min（T5）、拔出喉罩或气管导管前（T6）和拔出喉罩或气管导管即刻（T7）、1min（T8）、3min（T9）的SBP、DBP、平均动脉压（MAP）、Hg、脉搏血氧饱和度（SpO2）情况，并同时记录T3～T6时气道平台压（Pplat）、气道峰压（Ppeak），喉罩或气管导管置入时间、置入难度、咽喉疼痛、呛咳等并发症。结果与T1时比较，B组T2时的HR（116．3±15.4）明显增快（P〈0．05），8BP（114.5±12.4）、DBP（61．9±13.0）、MAP（83.9±13.6）明显升高（P〈0.05）；T2～T5、T7～T9时，B组HR快于A组（P〈0．05）；两组Ppeak比较，T3～T6时A组低于B组（P〈0.05）；两组并发症呛咳和咽喉疼痛比较，A组（0％、6.7％）的发生率低于B组（26.7％、46.7％）（P〈0.05）；两组喉罩或气管导管置入固定时间比较A组（12.2±2.2）s长于B组（4.8±1.9）s（P〈0.05）。结论喉罩应用于小儿全身麻醉对血流动力学影响小，气道压平稳，术后并发症少。
Objective To observe the effect of endotracheal intubation and classic laryngeal mask in pediatric anesthesia on hemodynamic effects and airway pressure, and to investigate safety of laryngeal mask in pediatric anaesthesia.Methods Thirty ASA I or 11 chidren,aged 3 to 9 years old,undergoing surgery under general anesthsia,were randomly into two groups;the ET group（group A） and LMA group（group B）,with fifteen cases in each group. The ET or LMA was inserted after general anaesthesia.SBP, DBP, MAP, HR, SpO = were recorded before and during anesthesia. Pplat and Ppeak were observed as well.The time of ET or LMA ,difficult, sore throat,bucking were recorded. Results Compared to T1SBP, DBP, MAP and HR in group B was significantly higher at T2（P〈0.05）.The HR of group B was faster than group A at T2-T5 and T7-T9（P〈0.05）. The Ppeak of group B were higher than group A at T 3-T 6 （P〈0.05）. The incidence of bucking and sore throat in group A was significantly lower than group B （P〈0.05）. The time of ET or LMA in group B was short than that in group A. Conclusion LMA can be safely and effectively used in airway management of pediatric anesthesia.
出处
《当代医学》
2013年第27期33-35,共3页
Contemporary Medicine
关键词
喉罩
气管内插管
小儿麻醉
Laryngeal mask
Endotracheal intubation
Pediatric anesthesia
