摘要
目的评价喉罩在双侧颅骨钻孔引流手术麻醉中的应用效果。方法选取64例拟行双侧颅骨钻孔引流手术的患者，按照电脑随机分组的原则分为研究组和对照组各32例。两组的麻醉方法均为全身麻醉，研究组使用喉罩的方式通气，对照组使用气管插管（经口明视）的方式通气。记录两组患者T0（术前）、T1（诱导后3min）、T2（插气管导管（喉罩）即时）、T3（手术开始时）、T4（术毕）、T5（拔除气管导管（喉罩）时）的血压、心率[MAP、HR]变化及PetCO2（呼末二氧化碳分压）、SpO2（血氧饱和度）的改变，记录手术耗时、拔除气管导管（或喉罩）时、血管活性药物（如阿托品、麻黄素）的应用情况及术中是否出现呛咳、术后有无咽部疼痛等情况。结果研究组丙泊酚、瑞芬太尼及维库溴铵用量均明显少于对照组[（142±26mg vs（180±30）mg，（231±49）μg vs．（292±48）μg，（5±1）mg vs.（8±2）mg],拔管时间明显短于对照组（3．6±0．7）min vs．（92±1．1）min]，气管导管或者喉罩的插入、拔除时研究组MAP和HR均低于对照组。差异均有统计学意义（P〈0．05）。研究组拔除喉罩时呛咳、咽喉部疼痛、管道带血等情况明显减少（3vs．28；2 vs.13；1vs．12），术中患者体动和呛咳等情况明显少于对照组[1vs．10；0vs.13），差异均有统计学意义（P〈0．05）。结论双侧颅骨钻孔外引流手术放置喉罩通气是一种可行的、有效的全身麻醉通气方式之一，其操作简易、所需麻醉药物较少、并发症少，可适用于双侧颅骨钻孔外引流手术的麻醉。
Objective To investigate the application effect of laryngeal mask airway （LMA） in double-side burr hole drainage surgery. Methods 64 patients who were prepared for double-side burr hole drainage surgery were randomly divided into research group （laryngeal mask airway） and control group （tracheal intubation）, 32 cases in each group. Monitored and recorded the changes of MAP （mean arterial blood pressure）, HR （heart rate）, SpO2 （pulse oxygen saturation） and PetCO2 （end-tidal carbon dioxide partial pressure） before the operation （To）, 3 rain after anesthesia induction （T0, at the time of tracheal intubation or laryngeal insertion （T2）, at the beginning of operation （T3）, at the end of surgery （T4）, and at the time of tracheal extubation or laryngeal drawing （T5）. Recorded total operation time, extubation or drawing time, the dosage of atropine and ephedrine, complications such as bucking, throat pain, etc. Results The dosages of propofol, remifentanyl, vecuronium and extubation time obviously decreased in research group [（142 ± 26） mg vs.（180± 30）mg, （231 ± 49）μg vs.（292 ± 48）lag, （5 ±1）mg vs.（8 ± 2）mg; （3.6 ±0.7）min vs.（9.2 ±1.1） min] （P 〈 0.05）. At T2 and T5, MAP and HR in research group significantly decreased compared with control group （P 〈 0.05）. The incidences of intraoperation movement and bucking in research group were obviously lower than those in control group （1 vs.10, 0 vs.13; P 〈 0.05）. Compared with control group, the incidences of bucking, sore throat and pipeline with blood in research group significantly decreased at Ts （3 vs.28, 2 vs.13, 1 vs.12; P 〈 0.05）. Conclusions LMA is a feasible and effective way of ventilation in general anesthesia. With the advantages of simple operation, less essential narcotic drug and less complications, LMA does apply to general anesthesia in double-side burr hole drainage surgery.
出处
《国际医药卫生导报》
2015年第2期204-207,共4页
International Medicine and Health Guidance News
关键词
喉罩
气管插管
钻孔引流术
全身麻醉
Laryngeal mask airway
Tracheal intubation
Burr hole drainage surgery
General anesthesia
