摘要
目的探讨喉罩通气技术用于妇科手术微创麻醉的可行性。方法美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级为Ⅰ~Ⅱ级妇科全身麻醉手术患者80例,随机分为两组(Ⅰ组:气管导管全身麻醉组;Ⅱ组:喉罩全身麻醉组),每组40例,均采用静脉吸入复合全身麻醉,麻醉诱导、维持及复苏所用药物种类相同,但Ⅰ组采用气管导管通气技术,Ⅱ组采用喉罩通气技术。记录并比较两组在不同时点的心率、血压数值,患者插管/置罩反应情况,麻醉复苏期患者耐受气管导管/喉罩情况及发生恶心、呕吐、呛咳、体动、咽喉痛等不良反应情况,统计并比较两组麻醉药物使用量,手术医师的满意度及患者的舒适度评分。结果与Ⅰ组比较,Ⅱ组在麻醉诱导气管插管后及麻醉复苏期拔管前的心率、心率,平均动脉压(mean arterial pressure,MAP)保持稳定(P<0.001),患者诱导期插管/置罩反应发生率、复苏期的不耐受率和不良反应发生率显著降低(P<0.001),患者的麻醉药物使用量明显降低(P<0.001),患者和手术医师的满意度明显增高(P<0.001)。结论喉罩通气是一种微创操作,具有置入快捷、刺激性小、血流动力学平稳、麻醉药物使用量少、并发症少、手术医生满意度高、患者舒适度高易于接受等优点,以其提供通气保障的静脉吸入全身麻醉方式是安全、有效的微创麻醉技术之一,值得在临床推广应用。
Objective The objective of this study was to investigate the feasibility of the use of laryngeal mask airway ventilation for minimally invasive gynecological surgery.Methods A total sample of80American Society of Anesthesiologists(ASA)classified I-II patients undergoing gynecological surgery under general anesthesia were randomly divided into2groups,with40cases in each group(group I:general endotracheal intubation anesthesia;group II:laryngeal mask airway for anesthesia).Both groups were given the same medications for the anesthesia induction,maintenance and recovery.Group I was ventilated via an endotracheal tube while group II was ventilated via a laryngeal mask airway.The heart rate and blood pressure values were recorded and compared between the two groups.The response and adverse reactions such as nausea,vomiting,coughing,body movement and sore throat were observed and compared between the two groups.The use of anesthesia medications was analyzed and compared.The satisfaction degree for surgeons and the comfort degree of patients were compared as well.Results Compared with the group I,the heart rate and mean arterial pressure(MAP)in group II were remarkably stable during the induction of anesthesia and the recovery period of anesthesia(P<0.001).The incidence of intubation/laryngeal mask airway placement reactions,the intolerance rate and the incidence of adverse reactions in group II were significantly lower(P<0.001).The use of narcotic medications in group II was significantly lower(P<0.001).The satisfaction degree of patients and surgeons in group II were significantly higher(P<0.001).Conclusions Placement of a laryngeal mask airway is minimally invasive with high-efficiency,less stimulation,more stable in hemodynamics,less dosage of anesthesia drug,fewer complications,greater degree of comfort,and is more acceptable by the patients,and worthy of clinical use and promotion.
作者
解温品
史亮
丁雪娇
俞慧
刘月琴
潘丽丽
朱石鹏
吕东东
刁宏山
XIE Wenpin;SHI Liang;DING Xuejiao;YU Hui;LIU Yueqin;PAN Lili;ZHU Shipeng;LYU Dongdong;DIAO Hongshan(Department of Anesthesiology, Shanghai Provincial Corps Hospital, Chinese People's Armed Police Force, Shanghai 201103, China)
出处
《中华灾害救援医学》
2017年第7期388-391,共4页
Chinese Journal of Disaster Medicine
关键词
喉罩
气管导管
通气技术
全身麻醉
微创麻醉
laryngeal mask airway
endotracheal tube
ventilation technology
general anesthesia
minimally invasive anesthesia
