摘要
目的探讨可视化技术定位喉罩插管对老年全麻病人血流动力学的影响。方法78例老年全麻病人,采用随机数表法分为观察组(采用可视化技术定位喉罩插管,39例)和对照组(采用气管插管,39例)。记录并比较2组病人入室安静后5 min(T0)、喉罩/气管导管插入前即刻(T1)、插入后即刻(T2)、插入后3 min(T3)、拔除时(T4)、拔除后即刻(T5)、拔除后3 min(T6)的心率(HR)、平均动脉压(MAP)变化情况,比较2组手术时间、麻醉时间、苏醒时间及麻醉药用量,并统计2组病人苏醒期并发症及术后早期并发症发生情况。结果观察组组内各时点HR差异无统计学意义(P>0.05),但观察组T2、T3、T5、T6时HR均显著低于对照组(P<0.05);对照组组内各时点HR差异有统计学意义(P<0.05),其中T1低于T0,T2、T3高于T0、T1、T4,T5高于T0~T4,T6高于T0、T1、T3、T4但低于T2、T5。2组组内各时点MAP差异均有统计学意义(P<0.05),其中观察组T1~T6时MAP水平均低于T0;对照组T1、T3、T4时MAP水平低于T0,T2、T5时MAP水平高于T0,T6又恢复至T0水平。观察组T2、T3、T5、T6时MAP水平显著低于对照组(P<0.05)。2组手术时间、麻醉时间、瑞芬太尼用量差异均无统计学意义(P>0.05);观察组苏醒时间显著短于对照组(P<0.01),丙泊酚用量显著低于对照组(P<0.01)。观察组呛咳体动、咽喉痛、吞咽痛发生率显著低于对照组(P<0.05),恶心呕吐、声嘶发生率较对照组差异无统计学意义(P>0.05)。结论可视化技术定位喉罩插管应用于老年全麻病人气道管理中安全可靠,相较于气管插管,其血液动力学平稳、并发症少,值得临床积极推广。
Objective To investigate the effect of visualized laryngeal mask airway intubation on hemodynamics in the elderly patients with general anesthesia.Methods Seventy-eight elderly patients with general anesthesia were randomly divided into observation group(receiving visualized laryngeal mask airway intubation,39 cases)and control group(receiving tracheal intubation,39 cases)by random number table method.The patients’heart rate(HR)and mean arterial pressure(MAP)at base value(T0),before intubation immediately(T1),after intubation immediately(T2),3 min after intubation(T3),when the tube drawing(T4),extubation immediately(T5)and 3 min after extubation(T6)were recorded and compared between the two groups.The operation time,anesthesia time,recovery time and anesthetic dosage were compared between the two groups,and the incidence rates of complications in recovery period and early postoperative period were recorded and compared.Results There was no significant difference in HR at all time points of the observation group(P>0.05),HR at T2,T3,T5 and T6 of the observation group were significantly lower than those of the control group(P<0.05).In the control group,the differences of HR at all time points were statistically significant(P<0.05),in which T1 was lower than T0;T2 and T3 were higher than T0,T1 and T4;T5 was higher than T0-T4;T6 was higher than T0,T1,T3 and T4,but lower than T2 and T5.There were significant differences in MAP at all time points of the two groups.In the observation group,the level of MAP at T0 was lower than that at T1-T6.In the control group,the level of MAP at T0 was higher than that at T1,T3 and T4,but lower than that at T2 and T5,and approximately equal to T6.The levels of MAP at T2,T3,T5 and T6 in the observation group were significantly lower than those in the control group(P<0.05).There were no significant differences in operation time,anesthesia time and the dosage of remifentanil between the two groups(P>0.05).The wake time of the observation group was significantly shorter than that of the control group(P<0.01).The dosage of propofol in the observation group was significantly lower than that in the control group(P<0.01).The incidence rates of cough,body movement,sore throat and swallowing pain in the observation group were significantly lower than those in the control group(P<0.05).There were no significant differences in the incidence rates of nausea,vomiting and hoarseness between the two groups(P>0.05).Conclusions Visualized laryngeal mask airway intubation is safe and reliable in the airway management of the elderly patients with general anesthesia.Compared with tracheal cannula,it has stable hemodynamics and fewer complications,which is worthy of clinical promotion.
作者
朱彤彤
王朝霞
齐悦
ZHU Tong-tong;WANG Chao-xia;QI Yue(Department of Anesthesiology, Liaoyang Central Hospital, Liaoyang 111000, China)
出处
《实用老年医学》
CAS
2021年第10期1058-1062,共5页
Practical Geriatrics
关键词
可视化技术
喉罩插管
气管插管
老年人
血流动力学
visualization technology
laryngeal mask airway intubation
tracheal cannula
aged
hemodynamics
