喉罩双相正压通气在中老年人无痛纤支镜诊疗术中的应用  

Application of bi-level positive airway pressure ventilation with laryngeal mask on anodynia fibreoptic bronchoscopic diagnosis and treatment in middle and older-aged population

作　　者：李颖芬[1] 董庆龙[1] 曾婉华[1] 

机构地区：[1]广州医学院第一附属医院麻醉科,广东广州510120

出　　处：《岭南现代临床外科》2010年第3期204-206,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨喉罩双相正压通气麻醉用于中老年患者行无痛纤维支气管镜诊疗的安全性和可行性。方法选择拟行纤维支气管镜诊疗的中老年病人20例,用丙泊酚、舒芬太尼和阿曲库铵行全凭静脉麻醉诱导和维持。根据患者体重置入相应大小的喉罩,在双相正压通气下行纤支镜诊疗术。记录麻醉前(T1)、喉罩置入后纤支镜进入前(T2)、纤支镜进入气道后5min(T3)、气道操作结束后1min(T4)和喉罩拔出患者清醒后5min(T5)的HR、MAP、SpO2的变化,记录术中发生呛咳、体动、低氧等不良事件。结果 T5时点的HR、MAP与T1比较无显著差异(P>0.05)。T5的SpO2比T1高(P<0.01);20例患者术中无1例出现呛咳、体动、低氧等不良事件。术吴病人陈述手术过程有不适感。结论全身麻醉下喉罩双相正压通气行纤维支气管镜诊疗是一安全、舒适、有利于内镜医师操作的麻醉方法。Objective To investigate the safety and feasibility of application of bi-level positive airway pressure ventilation with laryngeal mask on anodynia fibreoptic bronchoscopic diagnosis and treatment in middle-age and older-aged population.Methods Twenty patients were selected.All cases were induced and maintained for general anesthesia with propofol,sufentanil and atracurium,and were ventilated with bi-level positive airway pressure via laryngeal mask.Laryngeal mask of appropriate size was chosen according to body weight.The HR,mean arterial pressure(MAP) and SpO2 were recorded at the moments in preanesthesia(T1),before the bronchofiberscope inserted airway(T2),5 min after the bronchofiberscope inserted(T3),1 min in the end of airway manipulation(T4),and extubating laryngeal mask and 5 min after consciousness(T5).The bucking,body movement and hypoxia were recored during operation.Results Compared to T1 and T5,the HR and MAP were no significant difference(P>0.05).In the SpO2,the T5 was higher than that T1(P<0.01).Among the 20 cases,no 1 case occurred bucking,body movement and hypoxia were found.No patients complained discomfort during total operative course.Conclusion The bi-level positive airway pressure ventilation with laryngeal mask in general anesthesia is a safe and comfortable anesthetid method on the diagnosis and treatment of fibreoptic bronchoscope.

关 键 词：喉罩 全身麻醉 双相气道正压通气 纤支镜检查 

分 类 号：R614.2[医药卫生—麻醉学]