摘要
目的评估可视食管引流型、免充气(OPLAC)、Supreme喉罩在全麻剖宫产手术患者中的应用效果。方法择期合并椎管内麻醉禁忌证、拟于全身麻醉下行剖宫产术患者102例,采用随机数字表法,将患者随机分为3组(n=34):可视食管引流型喉罩组(V组)、OPLAC喉罩组(O组)、Supreme喉罩组(S组)。分别于麻醉诱导后置入可视食管引流型喉罩、OPLAC喉罩和Supreme喉罩,根据孕产妇体重选择不同喉罩型号。术前于预麻间行胃超声评估。麻醉诱导后置入喉罩,放置胃管后行机械通气。记录首要指标喉罩置入成功率,漏气发生情况及密封压,次要指标喉罩放置不良事件发生情况。结果与S组比较,V组首次置入成功率降低、漏气发生率升高、密封压降低,O组首要指标发生情况与S组相似;与S组比较,V组拔除喉罩后喉罩粘血和咽痛的发生率升高,O组发生率降低;与S组比较,V组纤维支气管镜检查等级评分4分患者减少,O组与S组相似;与S组比较,V组喉罩罩体旋转等级评分0分患者减少,O组与S组相似。3组患者术中SpO_(2)、P_(ET)CO_(2)未见差异,均未发现反流误吸证据。结论在择期全麻剖宫产气道管理中,可视食管引流型喉罩、OPLAC与Supreme喉罩均可保证有效通气,OPLAC与Supreme喉罩较可视食管引流型喉罩置入操作更简便、对位更准确,且OPLAC喉罩不良反应更少。
Objective To evaluate the applications of the visual esophageal drainage laryngeal mask,non-inflatable(OPLAC)and supreme laryngeal mask in parturients undergoing cesarean delivery(CD)in our hospital.Methods Totally 102 patients undergoing cesarean section under general anesthesia were selected.The patients were randomly divided into three groups(n=34),visual esophageal drainage laryngeal mask group(Group V)OPLAC laryngeal mask group(Group O),and supreme laryngeal mask group(Group S).Visual esophageal drainage,OPLAC and supreme laryngeal masks were placed after anesthesia induction,respectively,and different laryngeal masks were selected according to the maternal weight.Gastrointestinal ultrasound assessment was performed before anesthesia.The success rate of laryngeal mask placement,air leakage and sealing pressure,and adverse events of laryngeal mask placement were recorded.Results Compared with the Group S,the first placement success rate of Group V group was lower,with higher rate of air leakage and lower sealing pressure.The occurrence of the primary index of Group O was similar to the Group S.Comparing with Group S,the incidences of laryngeal mask sticky blood and sore throat after removing laryngeal mask was increased in the Group V,while they were reduced in Group O.Comparing with Group S,patients with fiberoptic bronchoscopy Grade 4 were reduced,while they were similar in Group O.Comparing with Group S,the patients with laryngeal mask body rotation Grade 0 in Group V were reduced,while they were similar in Group O.During the operation,there was no difference in SpO_(2) or P_(ET)CO_(2) among the 3 groups,and no evidence of reflux aspiration was found.Conclusion The visible esophageal drainage laryngeal mask,OPLAC and Supreme laryngeal mask can ensure effective ventilation in elective general anesthesia cesarean section airway management.The OPLAC and supreme laryngeal mask placement are easier,more accurate,and with less adverse reactions to the OPLAC laryngeal mask.
作者
阮孝国
郭高峰
孙铭阳
苌恩强
李宁涛
马丽斌
丛旭辉
李普乐
林必盛
张加强
RUAN Xiao-guo;SUN Ming-yang;CHANG En-qiang;LI Ning-tao;MA Li-bin;GUO Gao-feng;CONG Xu-hui;LI Pu-le;LIN Bi-sheng;ZHANG Jia-qiang(Department of Anesthesia,Henan Provincial People′s Hospital/Zhengzhou University People′s Hospital,Zhengzhou 450003,Henan,China;不详)
出处
《广东医学》
CAS
2022年第8期988-993,共6页
Guangdong Medical Journal
基金
河南省医学科技攻关计划省部共建项目(SB201901090)。
关键词
全麻
产科
剖宫产
喉罩
general anesthesia
obstetric
cesarean section
laryngeal masks
