摘要
目的观察Supreme喉罩静脉全麻在剖宫产术中应用的气道管理有效性和安全性。方法选择2013-2014年在中山市博爱医院进行静脉全麻下剖宫产术孕妇100例,其中择期手术60例,急诊手术40例,年龄24~41岁,体重58~87 kg,ASAⅠ或Ⅱ级,随机分为Supreme喉罩组（S组）50例和气管插管组（T组）50例。术中监测两组患者插管前、插管后、拔管前、拔管后心率（HR）和平均动脉压（MAP）变化,记录麻醉诱导后移除面罩至插管（喉罩）成功时间（T_1）、麻醉诱导后移除面罩至胎儿娩出时间（T_2）、新生儿Apgar评分、反流病例数、插管（喉罩）失败率、术后咽痛等不良反应。结果与S组比较,T组在插管后、拔管前、拔管后HR明显增快,MAP明显升高（P〈0.001）。T组产妇T_1较S组明显延长（P〈0.001）。两组患者T_2、气道峰压值和新生儿Apgar评分差异均无统计学意义（P〉0.05）。两组均无反流病例发生。T组术后咽痛患者11例,明显多于S组的3例（χ^2=5.316,P=0.021）。结论 Supreme喉罩插入和拔除操作对血流动力学无明显影响,术后不良反应少,可安全有效地用于剖宫产患者全麻气道管理。
Objective To explore the superiority and safety of supreme double-lumen laryngeal mask airway for cesarean section anesthesia. Methods A total of 100 full-term pregnant women with American Society of Anesthesiologists（ASA）I orⅡ physical status receiving cesarean section in of Zhongshan Bo′ai Hospital were recruited for the study in 2014. They were randomly divided into two groups,dual-chamber in the LMA group（S group of 50 cases）, tracheal intubation group（T group of 50 cases）. Heart rate（HR） and mean arterial pressure（MAP） were observed before and after intubation and extubation. The successful time of removing the mask after anesthesia induction to intubation（laryngeal mask）（T_1） and removing the mask after anesthesia induction to childbirth（T_2）, neonatal Apgar score, reflux cases, intubation（laryngeal mask） failure rate,postoperative adverse reactions such as sore throat were observed. Results Compared with S group, HR and MAP of T group were increased significantly after intubation, before and after extubation（ P〈0. 001）. T_1 of T group was obviously longer（P〈0.001）. The differences of T_2 and neonatal Apgar score between the two groups were not significant（P〈0.05）. Two groups had no reflux cases occurred. 11 patients of T group had postoperative sore throat, significantly more than 3 cases of S group（χ~2=5.316, P=0.021）. Conclusion The dual-chamber laryngeal mask airway for caesarean section anesthesia had no obvious effect on hemodynamic, less postoperative adverse reactions, which can be safely and effectively used in cesarean section patients for general anesthesia airway management.
出处
《热带医学杂志》
CAS
2016年第4期517-519,共3页
Journal of Tropical Medicine
关键词
全身麻醉
剖宫产
SUPREME喉罩
General anesthesia
Cesarean section
Supreme dual-chamber laryngeal mask
