摘要
目的探讨I-gel喉罩联合Coopdech支气管封堵器用于胸科手术中的安全性和可行性。方法选择60例全麻下行开胸手术患者,年龄20～65岁,ASAⅠ或Ⅱ级,随机分为两组,I-gel喉罩联合Coopdech支气管封堵器组（I组）和气管导管联合Coopdech支气管封堵器组（T组）。分别记录患者麻醉诱导前（T0）、麻醉诱导后（T1）、插入喉罩或气管导管即刻（T2）、手术结束时（T3）、拔除喉罩或气管导管即刻（T4）的MAP、HR;记录拔除喉罩或气管导管时间及苏醒时间,记录两组肺萎陷评分,记录两组单肺通气前、中及后的气道峰压（P1、P2和P3）;记录术后肺不张以及呛咳、咽喉疼痛、声音嘶哑等的发生情况。结果与T组比较,T2、T4时I组MAP明显降低,HR明显减慢（P〈0.05）;I组拔管时间和苏醒时间明显短于T组（P〈0.05）,肺萎陷评分两组差异无统计学意义;术后两组均无肺不张;与T组比较,I组P1、P2和P3差异无统计学意义,但术后呛咳、咽喉疼痛、声音嘶哑等不良反应明显减少（P〈0.05）。结论 I-gel喉罩联合Coopdech支气管封堵器用于胸科单肺通气时,气道密封性可靠,通气效果好。
Objective To observe the safety and efficacy of the combination of the I-gel laryngeal mask airway and the Coopdech bronchia blocker in thoracic surgery.Methods Sixty patients scheduled to undergoing thoracic surgery under general anesthesia were divided randomly into two groups,which were I-gel combined with bronchial blocker group（group I）and endotracheal tube combined with bronchial blocker group（group T）.The SDP,DBP and HR were recorded on indicated time points listedbelow：before induction（T0）,just after induction（T1）,insertion of laryngeal mask airway of entracheal tube（T2）,at the end of surgery（T3）,the Ppeak before（P1）,during（P2）and after（P3）one-lng ventilation;removal of the laryngeal mask airway or the endotracheal tube（T4）.Time to removal of the larygeal mask airway or the endotracheal tube were recorded.Scores of pulmonary collapse,pulmonary atelectasis after surgery diagnosed by chest X-ray,bucking,sore throat and hoarse voice were also recorded.Results MAP and HR were much lower in group I on times of T2 and T4compared with group T（P〈0.05）;Times to tracheal extubation and awaking of group I were shorter than group T（P〈0.05）.There were no significant differences on scores of pulmonary collapse between the two groups;No pulmonary atelectasis was found in all patients.Compared with group T,Ppeak in P1,P2 and P3had not difference in group I.Rates of adverse reaction including bucking,sore throat and hoarse voice were higher in group T（P〈0.05）.Conclusion I-gel laryngeal mask airway combined with coopdech bronchial blocker can provide effective airway seal and satisfied ventilation with less adverse reaction in one-lung ventilation in thoracic surgery.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2015年第6期569-572,共4页
Journal of Clinical Anesthesiology
基金
安徽省自然科学基金项目(编号:11040606M169)
关键词
I-gel喉罩
支气管封堵器
胸科手术
单肺通气
I-gel laryngeal mask airway
Bronchial blocker
Thoracic surgery
One-lung ventilation
