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Supreme喉罩在腹腔镜胆囊切除手术麻醉中的应用
Application of laryngeal mask airway supreme during anesthesia of laparoscopic cholecystectomy

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DOI:
作者:
朱俊峰
ZHU Jun-fen
作者单位:
上海交通大学附属六院金山分院
Department of Anesthesiology,The Jinshan sub-hospital of No.6 Hospital affiliated to Shanhai Jiaotong University,Shanghai 201500,China
关键词:
喉面罩；腹腔镜胆囊切除术
Laryngeal mask; laparosccopy cholecystectomy
摘要:
[摘 要] 目的 探讨Supreme喉罩（LMA-S）用于腹腔镜胆囊切除手术麻醉的安全性及可行性，并与传统气管插管（ETT）比较。方法 择期全麻下行腹腔镜胆囊切除手术的患者80例，性别不限，年龄18～72岁，ASAⅠ或Ⅱ级，Mallampatis Ⅰ～Ⅱ级，随机分为2组（n = 40）: LMA-S组（S组）和ETT组（T组）。记录2组喉罩（气管导管）置入时间及置入情况；记录S组胃管置入状况及气道密封压；记录2组喉罩（气管导管）置入后5 min（T1）、腹腔注气前5 min（T2）、腹腔注气后30 min（T3）、腹腔放气后5 min（T4）SpO2、PETCO2和气道峰压（Ppeak）；记录拔除喉罩（气管导管）后不良反应发生情况；记录2组手术麻醉时间、拔管时间和苏醒时间。结果 与T组比较，S组喉罩置入时间、拔管时间和苏醒时间短，拔除喉罩后咽痛、呛咳发生率低（P﹤0.05）；各时间点SpO2、PETCO2和Ppeak 均在正常范围，组间比较差异无统计学意义（p﹥0.05）；S组胃管置入成功率100%，喉罩气道密封压(25.2±3.8) cmH2O。结论 与气管导管相比，Supreme喉罩用于腹腔镜胆囊切除手术麻醉，操作简便，通气效果可靠，拔除后不良反应少。
[Abstract] Objective To explore the efficacy and possibility of laryngeal mask airway supreme (LMA-S) used in patients undergoing laparoscopic cholecystectomy and compared to endotracheal intubation. Methods Eighty ASAⅠorⅡ patients of both sexes aged 18～72 yr undergoing elective laparoscopic cholecystectomy were randomized to 2 groups (n = 40) : LMA -S group (group S) and endotracheal intubation group (group T) .Mallampati test was performed before operation in all groups,The patients were classified asⅠ～Ⅱ. The success rate,LMA placement/intubation time, success rate of gastric tube placement and airway seal pressure were recorded; SpO2、PETCO2、peak airway pressure were recorded at after 5 min of LMA placement/intubation（T1）、5 min before insufflation （T2）、30 min after insufflation（T3）、5 min after removal insufflation（T4）respectively; The duration of operation, anesthesia time,extubation time and emergence time were also recorded. Results The placement and removal time and emergence time were significantly shorter in group S than in group T; the incidence of choking and sore throat were significantly lower in group S than in group T ; SpO2、PETCO2、peak pressure were within normal range in both groups;The airway seal pressure were (25.2 ± 3.8) cmH2O in group S and the success rate of gastric tube placement were 100% .Conclusion LMA-S is superior to endotracheal intubation in terms of ease of insertion,efficacy of mechanical ventilation and sore throat.

 

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