摘要
目的 评价一次性双腔喉罩Supreme（laryngeal maskairway Supreme，SLMA）与反复使用型双腔喉罩ProSeal（laryngeal mask airway ProSeal，PLMA）用于Jb）L麻醉的效果及安全性。方法择期在全身麻醉下行手术的患儿60例，年龄9个月-5岁，体重10kg-20kg，美国麻醉医师协会（ASA）分级Ⅰ-Ⅱ级，采用随机数字表法随机分为SLMA组（S组）和PLMA组（P组），每组30例。麻醉诱导：咪达唑仑0．1mg／kg、阿托品0．01mg／kg、丙泊酚2mg／kg、芬太尼2μg／kg、罗库溴铵0．6mg／kg。记录置入喉罩的时间及难易度、首次置入成功率、口咽漏出压（oropharyngeal leak pressure，OLP）、胃管置入难易度，纤维支气管镜检查评定喉罩位置；记录置入喉罩前后患儿的心率、平均动脉压；记录术中患儿的吸入潮气量、呼出潮气量、气道峰压、肺顺应性以及拔除喉罩后不良事件与术后相关并发症的发生情况。结果S组OLP低于P组，分别为（19．7±2．2）cmH20（1cmH2O=0．098kPa）和（22．3±3．4）cmH2O（P〈0．05）两组患儿在喉罩置入时间、首次置人成功率、纤维支气管镜下对位分级、胃管置入难易度、术中血流动力学及呼吸参数变化、术后不良事件发生情况上差异无统计学意义。结论PLMA的气道密闭性较SLMA更好，两种喉罩均可安全有效地用于小儿麻醉。
Objective To compare the efficacy and safety of laryngeal mask airway Supreme （SLMA） and laryngeal mask airway ProSeal （PLMA） in paediatric patients undergoing general anesthesia. Methods Sixty ASA Ⅰ -Ⅱ children undergoing surgery with general anesthesia, 9 months to 5 years of age and 10 kg-20 kg in weight, were randomly divided into two groups （n=30）, SLMA group （group S） and PLMA group （group P）. 0.1 mg/kg midazolam, 0.01 mg/kg atropine, 2 mg/kg propofol, 2 txg/kg fentanyl and 0.6 mg/kg of rocuronium were used for induction of anesthesia. Insertion time, success rate of first insertion difficulty of airway device placement, oropharyngeal leak pressure （OLP）, difficulty of gastric access and fiberoptic determination of laryngeal mask airway （LMA） position were compared. Heart rate, mean arterial pressure were measured when inserting the LMA. Inspiratory tidal volume, expired tidal volume, peak airway pressure and compliance were recorded during the surgery. The postoperative complications were also compared. Results The OLP was lower in group S than that in group P [ （19.7 ±2.2） cmH2O vs （22.3 ±3.4） cmH2O ] （P〈0.05）（ 1 cmH2O=0.098 kPa）. There was no siginificant difference in insertion time, success rate of first insertion, difficulty of airway device placement, fiberoptic assessment, difficulty of gastric access and complications between two groups. Conclusions PLMA has a higher OLP and provides better sealing to the airway. Both of them can be efficacily used in pediatric general anesthesia.
出处
《国际麻醉学与复苏杂志》
CAS
2015年第2期134-137,共4页
International Journal of Anesthesiology and Resuscitation
关键词
喉罩
麻醉
全身
小儿
Laryngeal mask
Anesthesia, general
Paediatric
