摘要
目的探讨Supreme喉罩用于腹腔镜胆囊切除术患者气道管理的适宜套囊充气容积。方法择期全麻下行腹腔镜胆囊切除术患者90例,年龄18~64岁,体重50~70 kg,BMI 18~30 kg/m^2,ASA分级Ⅰ或Ⅱ级,Mallampati分级Ⅰ-Ⅲ级,气道管理均适合采用4号Supreme喉罩,采用随机数字表法分为3组(n=30):充气量10 ml组(V10组)、充气量20 ml组(V20组)和充气量30 ml组(V30组)。喉罩置入后测量套囊内压和喉罩漏气压。记录术中胃胀气、喉罩漏气和术后喉罩带血、咽喉部疼痛的发生情况。结果3组套囊内压随充气容积增加而升高[(23±5)、(37±4)、(60±6)cmH2O,P<0.05];而3组中V20组喉罩漏气压最高[(31.7±2.8)cmH2O、V10组(21.9±2.4)cmH2O、V30组(29.1±4.1)cmH2O,P<0.05];与V10组比较,V20组和V30组喉罩漏气发生率降低(P<0.05)。与V10组和V30组比较,V20组胃胀气发生率降低(P<0.05)。与V30组比较,V10组和V20组术后咽喉部疼痛发生率降低(P<0.05)。结论4号Supreme喉罩用于腹腔镜胆囊切除术患者全麻气道管理时,其适宜套囊充气容积为20 ml。
Objective To investigate the optimal cuff inflation volume of Supreme laryngeal mask airway(LMA)for airway management under general anesthesia in laparoscopic cholecystectomy.Methods Ninety American Society of Anesthesiologists physical statusⅠorⅡpatients,aged 18-64 yr,weighing 50-70 kg,with body mass index of 18-30 kg/m^2,of Mallampati gradeⅠ-Ⅲ,in whom size 4 Supreme LMA was suitable for airway management under general anesthesia,scheduled for elective laparoscopic cholecystectomy under general anesthesia,were divided into 3 groups(n=30 each)according to the cuff inflation volume:cuff volume 10 ml group(group V10),cuff volume 20 ml group(group V20)and cuff volume 30 ml group(group V30).The intercuff pressure(ICP)and oropharyngeal leak pressure(OLP)were measured after the Supreme LMA cuff was inflated to the predetermined volume.The peak airway pressure,tidal volume and end-tidal carbon dioxide pressure were monitored and recorded during operation.The occurrence of gastric distention and leakage during operation,blood stains on LMA and postoperative sore throat was recorded.Results The ICPs increased with the increasing inflation volume in three groups[(23±5),(37±4)and(60±6)cmH2O,P<0.05].The highest OLP[(31.7±2.8)cmH2O]was found in group V20,with OLP[(21.9±2.4)cmH2O]in group V10 and[(29.1±4.1)cmH2O]in group V30.Compared with group V10,the leakage rate of LMA was significantly decreased in V20 and V30 groups(P<0.05).Compared with V10 and V30 groups,the incidence of gastric distention was significantly decreased in group V20(P<0.05).Compared with group V30,the incidence of postoperative sore throat was significantly decreased in V10 and V20 groups(P<0.05).Conclusion When the size 4 Supreme LMA is used for airway management under general anesthesia in laparoscopic cholecystectomy,the optimal cuff inflation volume is 20 ml.
作者
尹琪
范云霞
朱光明
蒋鹏
Yin Qi;Fan Yunxia;Zhu Guangming;Jiang Peng(Department of Anethesiology,Affiliated Jintan Hospital of Jiangsu University,Changzhou 213200,China;Department of Anethesiology,Affiliated Hospital of Jiangsu University,Zhenjiang 212001,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2019年第12期1496-1500,共5页
Chinese Journal of Anesthesiology
基金
镇江市卫生计生科技重点专项项目(SHW2017001)
镇江市重点研发计划(社会发展)项目(SH2018082)
江苏省社会发展重点病种规范化诊疗项目(BE2015687)
江苏大学医学临床科技发展基金项目(JLY20160084)。
关键词
喉面罩
胆囊切除术
腹腔镜
呼吸
人工
Laryngeal mask
Cholecystectomy,laparoscopic
Respiration,artificial
