摘要
目的探讨预加温的可弯曲喉罩用于小儿斜视矫正术中麻醉气道管理的效果,以及其对患儿术后咽喉部并发症发生率的影响。方法选择2017年3月—2018年1月在复旦大学附属眼耳鼻喉科医院择期行全身麻醉下斜视矫正术的患儿120例,随机分为加温组和对照组,每组各60例。加温组在全身麻醉诱导前将可弯曲喉罩和0.9%氯化钠溶液置于40℃恒温箱中预加温30 min,麻醉诱导时以温热的0.9%氯化钠溶液润滑喉罩后置入;对照组则在麻醉诱导时将室温放置的可弯曲喉罩以室温放置的0.9%氯化钠溶液润滑后置入。两组喉罩置入均由同一位医师操作,喉罩套囊压力均为40 cmH 2O(1 cmH 2O=0.098 kPa)。记录两组患儿的一般情况,喉罩置入前、后平均动脉压和心率,喉罩置入时间和置入次数。使用纤维支气管镜对喉罩对位情况进行分级,测量并记录喉罩的气道密封压。术后记录患儿苏醒时间、手术时间和拔除喉罩后咽痛发生率。结果两组患儿的年龄,体重,身高,手术时间,苏醒时间,喉罩置入前、后的平均动脉压和心率,以及喉罩置入时间、次数、置入后气道密封压和纤维支气管镜分级的差异均无统计学意义(P值均>0.05)。拔除喉罩后,加温组患儿咽痛发生率[1.67%(1/60)]显著低于对照组[13.33%(8/60),P<0.05]。结论在斜视矫正术全身麻醉的气道管理中,使用加温预处理可弯曲喉罩,不会影响喉罩置入的操作和通气,可显著降低患儿术后咽痛的发生率。
Objective To investigate the effect of preheated flexible laryngeal mask airways(FLMAs)on airway management in children undergoing strabismus surgery and its influence on the incidence of postoperative laryngopharyngeal complications.Methods A total of 120 pediatric patients scheduled for elective strabismus surgery under general anesthesia in the Eye&ENT Hospital of Fudan University from March 2017 to January 2018 were enrolled in this study.They were randomly allocated to preheating group and control group(n=60).The mask and saline prepared for lubrication in the preheating group were placed in a 40℃incubator 30 min before induction of general anesthesia,and those in the control group were placed in room temperature.The cuff pressure was set to 40 cmH 2O(1 cmH 2O=0.098 kPa)and the procedure was manipulated by the same operator in both groups.The basic information,mean arterial pressure and heart rate before and after insertion,attempts and time of insertion,sealing pressure,mask position assessed by fibrobronchoscopy,recovery time and postoperative throat pain were recorded.Results There was no statistical difference between the two groups neither in age,weight,height,operation time,recovery time,mean arterial pressure or heart rate before and after laryngeal mask implantation,nor in the attempts and time of insertion,airway sealing pressure,the grade of mask position assessed by fibrobronchoscopy after implantation(all P>0.05).After the laryngeal mask was removed,the incidence of throat pain in the preheating group was significantly lower than that in the control group(1.67%[1/60],13.33%[8/60]vs.P<0.05).Conclusion In the airway management of general anesthesia for strabismus surgery,preheated FLMA does not affect the insertion and ventilation,and significantly reduces the incidence of postoperative throat pain in children.
作者
陈静
谭放
徐晓雁
张成
李双双
CHEN Jing;TAN Fang;XU Xiaoyan;ZHANG Cheng;LI Shuangshuang(Department of Anesthesiology,Eye&ENT Hospital,Fudan University,Shanghai 200031,China)
出处
《上海医学》
CAS
2021年第2期87-90,共4页
Shanghai Medical Journal
关键词
喉罩
可弯曲
预加热
斜视矫正术
咽喉部并发症
气道管理
Laryngeal mask airways
Flexible
Preheating
Strabismus surgery
Laryngopharyngeal complications
Airway Managemert
