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一次性双腔Supreme喉罩与ProSeal喉罩用于腹腔镜胆囊切除术(修改稿)
Comparison of Supreme laryngeal mask airway and ProSeal laryngeal mask airway in patients undergoing laparoscopic cholecystectomy
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DOI:
作者:
尤新民
JI Xiaoyan YOU Xinmin
作者单位:
新华医院崇明麻醉科
Department of Anesthesiology,Xinhua Hospital (zhong ming),Shanghai Jiaotong University Medical College,Shanghai 202150, China
关键词:
【关键词】 喉罩; 麻醉; 腹腔镜胆囊切除术
【Key words】laryngeal mask airway;Anesthesia,Laparoscopic cholecystectomy
摘要:
【摘要】 目的 评价双腔Supreme喉罩(SLAM)与ProSeal喉罩(PLAM)用于腹腔镜胆囊切除术气道管理效果的比较。方法 择期全麻下行腹腔镜胆囊切除术的患者100例,性别不限,年龄38~65岁,体重51~85kg,ASAI~II级,随机分为SLAM组(S组) 和PLAM组(P组)两组(n=50)。静脉注射咪达唑仑0.1mg/kg(最大5mg),丙泊酚1.5-2mg/kg,芬太尼0.1mg,维库溴铵0.1mg/kg麻醉诱导后置入喉罩,并经引流管置入胃管。记录置入喉罩时间和置入情况,应用纤支镜检查喉罩位置并评分,记录各时点的HR、AMP、SpO2、PETCO2、气道峰压(Ppeak) 和气道密封效果。记录拔除喉罩后不良反应的发生情况、手术时间、麻醉时间、拔管时间和苏醒时间。结果 两组喉罩置入时间、置管成功率、手术时间、麻醉时间、拔管时间和苏醒时间,拔除喉罩后低氧血症、呛咳、咽喉痛的发生率无统计意义。两组无返流误吸发生。各时点HR、AMP、SpO2、PETCO2、 和Ppeak均在正常范围内, 两组气道密封压分别为25±4cmH2O和24±3cmH2O,组间比较差异无统计意义(P>0.05)。两组喉罩对位准确率均为98%,胃管放置成功率均为100%。结论 SLAM气道密封性可靠,可行正压通气且通气效果确切有效,拔除后不良反应少。可安全有效地用于腹腔镜胆囊切除术患者的全麻气道管理。 【关键词】 喉罩; 麻醉; 腹腔镜胆囊切除术
Comparison of Supreme laryngeal mask airway and ProSeal laryngeal mask airway in patients undergoing laparoscopic cholecystectomy JI Xiaoyan YOU Xinmin.Department of Anesthesiology,Xinhua Hospital (zhong ming),Shanghai Jiaotong University Medical College,Shanghai 202150, China Corresponding author: YOU Xinmin. E-mail:babayouxinmin@hotmail.com 【Abstract】 Objective Comparison of Supreme laryngeal mask airway (SLAM)and ProSeal laryngeal mask airway (PLAM)in patients undergoing laparoscopic cholecystectomy. Methods one hundred ASAI~II patients of both sexes aged 38~65yr weighing 51-85 kg undergoing laparoscopic cholecystectomy were randomized to 2 groups(n=50 each):SLAM group (group S)and PLAM group(group P).In group S and group P were inserted after induction of anesthesia with midazolam 0.1mg/kg(maximum 5mg), fentanyl 0.1mg,propofol 1.5-2.0mg/kg and vecuronium0.1mg/kg.A gastric tube was inserted through the drain tube .The success rate, LAM placement/intubation time, success rate of gastric tube placement, airway seal pressure, SpO2, PETCO2, peak airway pressure and complications (hypoxemia, nausea and vomiting, choking hoarseness, sore throat and regurgitation of gastric contents)were recorded. The airway sealing effect of LMA. was examined , Fiberoptic bronchoscope was inserted into the airway tube of LMA to check its position were recorded. The duration of surgery, anesthesia time, extubation time, and emergence time, were also recoded. Results There was no significant difference in the success rate、the placement and removal time and recovery time between the two groups. The airway seal pressure was(25+4)cmH2O in group S and (24+3)cmH2O in group P .The SpO2, PETCO2, peak airway pressure were within normal range in both groups. The incidence of postoperative hypoxemia, nausea and vomiting, choking hoarseness, sore throat and regurgitation of gastric contents were within normal range in both groups. Conclusion SLAM can provide adequate ventilation during operation with less complications and can be used effectively for laparoscopic cholecystectomy 【Key words】laryngeal mask airway;Anesthesia,Laparoscopic cholecystectomy
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